Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-0784
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
1045 N GRAND AVE, MT PLEASANT, IA 52641-3111
(319) 385-8600
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
622
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0427708
—
IA
01
—
2027987
PK
—
05
—
228049
—
IA
Enumeration date
07/16/2006
Last updated
06/04/2025
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