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General NPI Number Information
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NPI Number | 1548711484
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Entity Type | Organization
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Legal Business Name | WAL-MART PHARMACY
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Dates
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Enumeration Date | 10/15/2016
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Last Update Date | 10/15/2016
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Provider Practice Location Address
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Address Line | 2200 S ROCK RD APARTMENT 1014
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City | WICHITA
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State | KS
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Zip | 67207-5300
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Country | US
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Telephone | 734-945-9043
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 S ROCK RD APARTMENT 1014
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City | WICHITA
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State | KS
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Zip | 67207-5300
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MUNJAL ATTAWALA
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Credential |
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Telephone | 734-945-9043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 1-100436
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License Number State | KS
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