Wal-Mart Stores Texas LLC

NPI #1639196801 in Sulphur Springs, Texas

Provider Information

NPI Number
1639196801
Entity Type
Organization
Organization Name
Wal-Mart Stores Texas LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jul 16, 2006
Last Updated
Jun 3, 2025

Practice Location

Address
1750 S BROADWAY ST
State
Texas
ZIP Code
75482-4902
Phone
(903) 885-1578

Authorized Official

Name
KIMBERLY CANONIC
Title
SENIOR DIRECTOR, ENROLLMENT
Phone
(480) 277-6348

Specialties & Taxonomy Codes

Specialty
Pharmacy
Durable Medical Equipment & Medical Supplies
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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