Walmart Pharmacy 10-2688
LBN: Wal-Mart Stores Texas Llc
Walmart Pharmacy 10-2688 is an health care organization with primary practice located at 6801 S Broadway Ave , Tyler TX 75703-4733. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Wal-Mart Stores Texas Llc can be contacted via phone (903) 581-4842, or through Little, Sarah via phone (479) 277-2500.
Contact Information
Primary practice address
6801 S Broadway Ave
Tyler TX 75703-4733
Phone: (903) 581-4842
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 21621 | Texas |
Profile Details
| NPI number | 1124047139 |
|---|---|
| LBN Legal business name | Wal-Mart Stores Texas Llc |
| DBA Doing business as | Walmart Pharmacy 10-2688 |
| Authorized official | Little, Sarah |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 19th, 2006 |
| Last updated | Aug 29th, 2023 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124047139 | NPPES |
| Other | 2096019 | PK | |
| MEDICAID | 469502 | PK |
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