Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-3729
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
5065 PYRAMID WAY, SPARKS, NV 89436-7703
(775) 425-9331
(775) 425-9333
Mailing address
702 SW 8TH STREET, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH02112
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100508377
—
NV
01
—
2052122
PK
—
05
—
PH02112
—
NV
Enumeration date
07/16/2006
Last updated
07/08/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us