Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-3360
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
2750 E GERMANN RD, CHANDLER, AZ 85286-1403
(480) 812-2942
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y004319
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1991931
PK
—
05
—
4319
—
AZ
05
—
979940
—
AZ
Enumeration date
01/03/2007
Last updated
06/19/2025
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