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NPI Code Detail

MEDICARE: WAL-MART STORES, INC.

MEDICARE: WAL-MART STORES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1156FX1800XOptician
2332H00000XEyewear Supplier

General Provider Information

NPI Number : 1275696361
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAL-MART STORES, INC.
Provider Business Mailing Address
First Line : 702 SW 8TH ST.
Second Line :
City : BENTONVILLE
State : AR
Zip : 72716-0445
Country : US
Telephone Number : 479-277-2500
Fax Number : 479-277-4331
Provider Business Practice Location Address
First Line : 6150 S 35TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85041-5004
Country : US
Telephone Number : 602-243-8523
Fax Number : 602-243-8525
Authorized Official
Title or Position : DIRECTOR HEALTHCARE CONTRACTING
Name : SARAH LITTLE
Credential :
Telephone Number : 479-277-2500
Provider Enumeration Date : 12/19/2006
Last Update Date : 07/21/2022

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Directions to “WAL-MART STORES, INC. ” Practice Location

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