Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-1005
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
2700 4TH ST SW, WAVERLY, IA 50677-4351
(319) 352-2735
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
163
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0245290
—
IA
01
—
2028109
PK
—
05
—
245290
—
IA
Enumeration date
07/16/2006
Last updated
06/04/2025
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