Organization
WAL-MART STORES TEXAS, LLC
Active
Other names
Walmart Pharmacy 10-1250
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR)
(480) 853-0515
Entity
Organization
Contact information
Practice address
400 ICY TRL, CELINA, TX 75009-5780
(972) 382-0133
(972) 382-0135
Mailing address
1 CUSTOMER DR, MAIL STOP 0445, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
01/13/2026
Last updated
01/13/2026
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