Organization
WALMART INC.
Active
Other names
Walmart Pharmacy 10-3377
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
2823 W VALENCIA RD, TUCSON, AZ 85746-8034
(520) 908-2563
(520) 908-2565
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y004381
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024277
—
AZ
01
—
1991958
PK
—
05
—
4381
—
AZ
Enumeration date
01/03/2007
Last updated
06/19/2025
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