Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-4460
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
12001 MAUMELLE BLVD, N LITTLE ROCK, AR 72113-7274
(501) 851-6459
(501) 851-6507
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20577
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167277407
—
AR
01
—
1989838
PK
—
Enumeration date
01/16/2008
Last updated
07/14/2025
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