Organization
WAL-MART PUERTO RICO INC
Active
Other names
WALMART PHARMACY 10-2501
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
501 AVE WEST MAIN, PLAZA DEL SOL, BAYAMON, PR 00961-4458
(787) 740-0730
(787) 740-0620
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
18-F-2422
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2087531
PK
—
Enumeration date
02/12/2007
Last updated
06/05/2025
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