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Organization

WALMART INC.

Active
Other names
WALMART PHARMACY 10-2074
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization

Contact information

Practice address
1350 S SEWARD MERIDIAN PKWY, WASILLA, AK 99654-8332
(907) 376-9783
(907) 376-9785
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
342
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1996858
PK
05
PH0252
AK
Enumeration date
07/16/2006
Last updated
06/05/2025
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