Walmart Inc.

NPI #1114944410 in Rockford, Illinois

Provider Information

NPI Number
1114944410
Entity Type
Organization
Organization Name
Walmart Inc.
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jul 16, 2006
Last Updated
Jun 13, 2025

Practice Location

Address
3902 W RIVERSIDE BLVD
ZIP Code
61101-9507
Phone
(815) 962-4763

Authorized Official

Name
KIMBERLY CANONIC
Title
SENIOR DIRECTOR, ENROLLMENT
Phone
(480) 853-0515

Specialties & Taxonomy Codes

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

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