Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-4473
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
2175 W RUTHRAUFF RD, TUCSON, AZ 85705-1241
(520) 292-2549
(520) 292-2551
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 258-6724
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y004971
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992675
PK
—
Enumeration date
01/16/2008
Last updated
07/14/2025
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