# WALMART INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013072123
- **Authorized official:** KIMBERLY CANONIC (SENIOR DIRECTOR ENROLLMENT)
- **Authorized official phone:** (480) 853-0515

## Contact information

- **Practice address:** 2228 W 1700 S, SYRACUSE, UT 84075-7126
- **Practice address phone:** (801) 775-9880
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-6209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 63758311703 | UT | Yes |

## Other

- **Enumeration date:** 12/27/2006
- **Last updated:** 07/08/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2100909 | PK | — |