Organization
WALMART INC.
Active
Other names
Walmart Pharmacy 10-6477
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
9600 N METRO PKWY W, PHOENIX, AZ 85051-1402
(480) 337-0256
(480) 337-0257
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 258-2115
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y007255
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2169705
PK
—
05
—
331178
—
AZ
Enumeration date
04/26/2017
Last updated
06/09/2025
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