Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-4356
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
7200 ARROYO CROSSING PKWY, LAS VEGAS, NV 89113-4058
(702) 270-2523
(702) 270-2774
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH02324
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386826022
—
NV
01
—
2052273
PK
—
Enumeration date
12/05/2007
Last updated
07/09/2025
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