Organization
WALMART INC.
Active
Other names
Walmart Pharmacy 10-3129
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR)
(480) 853-0515
Entity
Organization
Contact information
Practice address
14100 LIMONITE AVE, EASTVALE, CA 92880-3855
(909) 563-2577
(909) 563-2578
Mailing address
1 CUSTOMER DR, MAIL STOP 0445, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Enumeration date
01/02/2026
Last updated
01/02/2026
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