Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-4335
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
11550 MERIDIAN MARKET VW, FALCON, CO 80831-8241
(719) 522-2989
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
693
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1997754
PK
—
05
—
24489867
—
CO
05
—
84489867
—
CO
Enumeration date
05/31/2007
Last updated
07/09/2025
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