Organization
WALMART INC.
Active
Other names
Walmart Pharmacy 10-3742
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
1486 DIKE ACCESS RD, WOODLAND, WA 98674-9359
(360) 225-9604
Mailing address
702 SW 8TH ST., BENTONVILLE, AR 72716
(479) 258-2115
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
CF60199637
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2127452
PK
—
Enumeration date
10/28/2010
Last updated
07/08/2025
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