Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-3620
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
13502 S HAMILTON VIEW RD, RIVERTON, UT 84065-6059
(801) 446-2981
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
6970107-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700062148
—
UT
01
—
2100980
PK
—
Enumeration date
01/16/2008
Last updated
07/02/2025
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