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Organization
WALMART INC.
Active
Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-3712
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
7010 AUBURN BLVD, CITRUS HEIGHTS, CA 95621-4342
(916) 729-8069
(916) 729-8076
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY48383
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2111832
PK
—
05
—
463PHA483830
—
CA
Enumeration date
12/27/2006
Last updated
07/02/2025
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