Organization
WALMART INC.
Active
Other names
Walmart Pharmacy 10-4376
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
1400 N WALTON BLVD, BENTONVILLE, AR 72712-4676
(479) 268-9830
(479) 268-9831
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(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
AR20802
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207682407
—
AR
01
—
2151290
PK
—
Enumeration date
04/07/2015
Last updated
07/09/2025
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