| Organization Name: | WALMART |
| NPI Number: | 1053789065 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HIEDI MASON (PHARMACIST) |
| Mailing Address: | 2510 Cantrell Rd Little Rock |
| State: | AR US |
| Postal Code: | 722022116 |
| Phone Number: | 5017073607 |
| Fax Number: | |
| NPI Enumeration Date: | 09/08/2015 |
| NPI Last Update Date: | 09/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | PD12269 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |