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General NPI Number Information
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NPI Number | 1699142539
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Entity Type | Organization
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Legal Business Name | WAL-MART
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Dates
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Enumeration Date | 08/26/2015
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Last Update Date | 08/26/2015
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Provider Practice Location Address
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Address Line | 12270 PARAMOUNT BLVD
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City | DOWNEY
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State | CA
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Zip | 90242-3549
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Country | US
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Telephone | 562-622-4891
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Fax |
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Provider Business Mailing Address
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Address Line | 12270 PARAMOUNT BLVD
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City | DOWNEY
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State | CA
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Zip | 90242-3549
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Country | US
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Telephone | 562-622-4891
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | LINDA LAM
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Credential | PHARM D.
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Telephone | 951-313-2770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 71599
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License Number State | CA
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