Walmart Inc.

NPI #1093163990 in Caldwell, Idaho

Provider Information

NPI Number
1093163990
Entity Type
Organization
Organization Name
Walmart Inc.
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jun 1, 2016
Last Updated
Jun 10, 2025

Practice Location

Address
622 W USTICK RD
State
Idaho
ZIP Code
83605-6248
Phone
(208) 453-2852

Authorized Official

Name
KIMBERLY CANONIC
Title
SENIOR DIRECTOR, ENROLLMENT
Phone
(480) 277-6348

Specialties & Taxonomy Codes

Specialty
Pharmacy
Durable Medical Equipment & Medical Supplies
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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