Organization
WALMART INC.
Active
Other names
WalMart Pharmacy 10-3127
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
5141 CHAMBERS RD, DENVER, CO 80239-4231
(303) 218-6242
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
PDO-848
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2135112
PK
—
05
—
31004857
—
CO
Enumeration date
05/03/2012
Last updated
06/06/2025
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