Organization
WALMART INC.
Active
Other names
Walmart Pharmacy 10-2997
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
616 N GARLAND AVE STE 363, SUITE 363, FAYETTEVILLE, AR 72701-3116
(479) 443-1658
(479) 443-8038
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
AR20640
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100238800A
—
OK
05
—
1174824395
—
MO
05
—
186892407
—
AR
01
—
2127442
PK
—
Enumeration date
11/04/2010
Last updated
06/05/2025
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