Organization
WALMART INC.
Active
Other names
Walmart Pharmacy 10-5461
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
14505 NE FOURTH PLAIN BLVD, VANCOUVER, WA 98682-5003
(360) 258-2653
(360) 258-2652
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
PHAR.CF.60581870
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2152781
PK
—
Enumeration date
06/23/2015
Last updated
06/18/2025
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