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Organization
WALMART INC.
Active
Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-1963
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
2111 FULKERTH RD, TURLOCK, CA 95380-9515
(209) 634-8546
(209) 634-8548
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY39262
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2066053
PK
—
05
—
463PHA392620
—
CA
Enumeration date
07/16/2006
Last updated
06/09/2025
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