<Unavail>
LBN: Wal-Mart Stores Texas Llc
<Unavail> is an health care organization with primary practice located at 5154 Knickerbocker Rd , San Angelo TX 76904-7714. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Wal-Mart Stores Texas Llc can be contacted via phone (325) 276-6620, or through Canonic, Kimberly via phone (480) 853-0515.
Contact Information
Primary practice address
5154 Knickerbocker Rd
San Angelo TX 76904-7714
Phone: (325) 276-6620
Fax: (325) 276-6619
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 30612 | Texas |
Profile Details
| NPI number | 1255791562 |
|---|---|
| LBN Legal business name | Wal-Mart Stores Texas Llc |
| DBA Doing business as | <Unavail> |
| Authorized official | Canonic, Kimberly |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 29th, 2016 |
| Last updated | Jun 12th, 2025 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255791562 | NPPES |
| Other | 2158818 | PK | |
| MEDICAID | 470388 | PK |
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