Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-4256
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
534 S DUFF AVE, AMES, IA 50010-6863
(515) 956-3547
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1340
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2030470
PK
—
Enumeration date
12/05/2007
Last updated
07/09/2025
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