Organization
WALMART INC.
Active
Other names
Walmart Pharmacy 10-5706
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
700 S BOWMAN RD, LITTLE ROCK, AR 72211-3616
(501) 859-8710
(501) 859-8704
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20684
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197015407
—
AR
01
—
2136764
PK
—
Enumeration date
08/31/2012
Last updated
07/07/2025
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