Provider Demographics
NPI:1073760880
Name:WAL-MART STORES INC
Entity Type:Organization
Organization Name:WAL-MART STORES INC
Other - Org Name:WAL-MART PHARMACY 10-5901
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTHCARE ENROLLMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-277-1242
Mailing Address - Street 1:702 SW 8TH STREET
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72716-0445
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:838 WEST ELLIOT ROAD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233
Practice Address - Country:US
Practice Address - Phone:480-539-0741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy