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Organization
WAL-MART PUERTO RICO INC
Active
Organization
WAL-MART PUERTO RICO INC
Active
Other names
WalMart Pharmacy 10-2302
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
CARR 2 KM56.80, BARCELONETA, PR 00617-3141
(787) 970-8107
(787) 970-8110
Mailing address
1 CUSTOMER DR, MS 0445, BENTONVILLE, AR 72716-6209
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
18-F-2880
PR
Other
Enumeration date
07/01/2010
Last updated
07/17/2026
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