Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-0279
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
926 E COLLIN RAYE DR, DE QUEEN, AR 71832-9400
(870) 642-6921
(870) 642-6815
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
AR14021
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100231710A
—
AR
05
—
110272407
—
AR
01
—
1994547
PK
—
05
—
225842716 DME
—
AR
Enumeration date
07/16/2006
Last updated
05/30/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us