Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-4232
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
4747 E CACTUS RD, PHOENIX, AZ 85032-7725
(602) 404-3722
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y004907
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992595
PK
—
Enumeration date
07/20/2007
Last updated
07/14/2025
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