Organization
WALMART INC.
Active
Other names
Walmart Pharmacy 10-5725
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
831 E FORT LOWELL RD, TUCSON, AZ 85719-2109
(520) 719-6340
(520) 719-6348
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
Y007150
AZ
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168023
PK
—
05
—
261778
—
AZ
Enumeration date
02/09/2017
Last updated
06/10/2025
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