Organization
WALMART INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
715 N MAIN STREET, TAYLOR, AZ 85939
(928) 536-6885
(928) 536-7933
Mailing address
702 SW 8TH ST, MS 0445, BENTONVILLE, AR 72716-0445
(479) 277-1242
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y006607
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105306
—
AZ
01
—
2156214
PK
—
Enumeration date
12/28/2015
Last updated
07/09/2025
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