Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-2352
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
2101 2ND AVE SE, CAMBRIDGE, MN 55008-4137
(763) 689-0609
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
261296
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084320200
—
MN
01
—
2047392
PK
—
05
—
84320200
—
MN
Enumeration date
07/16/2006
Last updated
06/02/2025
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