Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-2203
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
909 SE J ST SUITE 5, BENTONVILLE, AR 72716-0000
(479) 418-0751
(479) 418-0750
Mailing address
1 CUSTOMER DR, MS 0445, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR18081
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123700407
—
AR
01
—
1995377
PK
—
Enumeration date
07/19/2006
Last updated
09/29/2025
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