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Organization
WAL-MART STORES TEXAS LLC
Active
Organization
WAL-MART STORES TEXAS LLC
Active
Other names
Walmart Pharmacy 10-7362
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
2035 SE 34TH AVE, AMARILLO, TX 79103-1705
(806) 513-6391
(806) 513-6392
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
29547
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149119
PK
—
05
—
470484
—
TX
Enumeration date
10/07/2014
Last updated
06/09/2025
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