Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-4394
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
1221 S HAYFORD RD, SPOKANE, WA 99224-7023
(509) 459-0614
Mailing address
702 SW 8TH STREET, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
CF00059199
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2109152
PK
—
05
—
6031256
—
WA
Enumeration date
07/20/2007
Last updated
07/10/2025
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