Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-0261
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
4019 CENTRAL AVE, HOT SPRINGS, AR 71913-7208
(501) 623-7689
(501) 623-5104
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR12091
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100756407
—
AR
05
—
152916716 DME
—
AR
01
—
1994216
PK
—
Enumeration date
07/19/2006
Last updated
05/29/2025
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