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Organization
WALMART INC.
Active
Organization
WALMART INC.
Active
Other names
Walmart Pharmacy 10-2464
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
8270 DELTA SHORES CIR S, SACRAMENTO, CA 95832-9101
(916) 665-1052
(916) 665-1055
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 258-2115
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY55800
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336661461
—
CA
01
—
2171006
PK
—
Enumeration date
07/11/2017
Last updated
06/12/2025
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