Organization
WALMART INC.
Active
Other names
WalMart Pharmacy 10-3897
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
252 CHENEY DR W, TWIN FALLS, ID 83301-3721
(208) 736-3387
(208) 736-3738
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
2336RP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2119983
PK
—
05
—
808396900
—
ID
Enumeration date
04/08/2009
Last updated
07/08/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us