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Organization
WALMART INC.
Active
Organization
WALMART INC.
Active
Other names
Walmart Pharmacy 10-3123
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
3255 MISSION COLLEGE BLVD, SANTA CLARA, CA 95054-1829
(408) 961-4480
Mailing address
702 SW 8TH STREET, BENTONVILLE, AR 72716
(479) 273-4885
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
51749
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144320
PK
—
Enumeration date
12/20/2013
Last updated
06/06/2025
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