Organization
WALMART INC.
Active
Other names
WalMart Pharmacy 10-4430
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
41650 W MARICOPA CASA GRANDE HWY, MARICOPA, AZ 85138-3206
(520) 568-3302
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y005113
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2119684
PK
—
05
—
433802
—
AZ
Enumeration date
03/27/2009
Last updated
07/11/2025
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