Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-4244
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
1303 CHARLES ST, PARK RAPIDS, MN 56470-1241
(218) 732-0329
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
262975
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2049220
PK
—
05
—
333907000
—
MN
Enumeration date
03/14/2007
Last updated
07/08/2025
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