Organization
WALMART INC.
Active
Other names
Walmart Pharmacy 10-6178
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
10400 E COLFAX AVE, AURORA, CO 80010-5019
(303) 537-9809
(303) 537-9810
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
PDO.1680000083
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148716
PK
—
Enumeration date
11/04/2014
Last updated
06/09/2025
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