Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-4323
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
505 RIVERSTONE PKWY, KANKAKEE, IL 60901-7207
(815) 802-3166
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054016412
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2023653
PK
—
Enumeration date
12/05/2007
Last updated
07/09/2025
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