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Organization
WAL-MART STORES TEXAS LLC
Active
Organization
WAL-MART STORES TEXAS LLC
Active
Other names
Walmart Pharmacy 10-5226
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (DIRECTOR, ENROLLMENT SERVICES)
(480) 277-6348
Entity
Organization
Contact information
Practice address
9526 W MILITARY DR, SAN ANTONIO, TX 78251-1905
(210) 536-2090
(210) 536-2091
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
29132
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295152270
—
TX
01
—
2145363
PK
—
05
—
469178
—
TX
Enumeration date
03/27/2014
Last updated
06/06/2025
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