Organization
WALMART INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
1500 HIGHWAY 25B, HEBER SPRINGS, AR 72543-0419
(501) 362-5837
(501) 362-2864
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
AR15047
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113327407
—
AR
01
—
1994792
PK
—
Enumeration date
07/17/2006
Last updated
05/30/2025
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