Organization
WALMART INC.
Active
Other names
Walmart Pharmacy 10-6971
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
240 SLACK ST, PEA RIDGE, AR 72751-3759
(479) 451-9008
(479) 451-9011
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 273-4000
(479) 273-4000
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20751
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204099407
—
AR
01
—
2145377
PK
—
Enumeration date
03/25/2014
Last updated
06/10/2025
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