Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-0289
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
1001 HIGHWAY 65 S, MC GEHEE, AR 71654-9417
(870) 222-6233
(870) 222-6334
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-1258
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR17851
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123345407
—
AR
01
—
1995283
PK
—
Enumeration date
07/26/2006
Last updated
05/29/2025
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