# WALMART INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699915124
- **Authorized official:** KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
- **Authorized official phone:** (480) 277-6348

## Contact information

- **Practice address:** 136 W STATE ROAD 73, SARATOGA SPRINGS, UT 84045-2900
- **Practice address phone:** (801) 766-0732
- **Mailing address:** 702 SW 8TH ST., MAIL STOP 0445, BENTONVILLE, AR 72716-6209
- **Mailing address phone:** (479) 277-1242
- **Mailing address fax:** (479) 277-4331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 7275814-1703 | UT | Yes |

## Other

- **Enumeration date:** 02/24/2009
- **Last updated:** 07/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1699915124 | — | UT |
| 01 | — | 2119372 | PK | — |