Organization
WALMART INC.
Active
Organization
WALMART INC.
Active
Other names
Walmart Pharmacy 10-4474
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (CMS ESMD EMDR)
(480) 853-0515
Entity
Organization
Contact information
Practice address
10096 KENAI SPUR HWY, KENAI, AK 99611-7807
(907) 395-0871
(907) 395-4038
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHAR470
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2123564
PK
—
05
—
PH0021
—
AK
Enumeration date
01/22/2010
Last updated
07/14/2025
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