Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-3867
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
200 W 136TH AVE, WESTMINSTER, CO 80234-1204
(720) 929-1770
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
673
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003888
PK
—
05
—
87620553
—
CO
Enumeration date
12/27/2006
Last updated
07/08/2025
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