Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-0652
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
3101 E KANSAS AVE, GARDEN CITY, KS 67846-7070
(620) 275-7557
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
2-08852
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100433210A
—
KS
01
—
2032405
PK
—
05
—
6010831815
—
KS
Enumeration date
07/16/2006
Last updated
06/03/2025
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