Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-3758
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
1930 SAHLSTROM DR, CROOKSTON, MN 56716-2819
(218) 281-6170
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
263060
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2049239
PK
—
05
—
906660100
—
MN
Enumeration date
06/29/2007
Last updated
07/07/2025
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