Organization
WALMART INC.
Active
Other names
WalMart Pharmacy 10-3128
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
1442 S PARKER RD, DENVER, CO 80231-2707
(303) 481-3520
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PDO-847
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15051358
—
CO
01
—
2134866
PK
—
Enumeration date
04/23/2012
Last updated
06/06/2025
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