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NPI 1467470252

NPI 1467470252 : WALMART INC. : SACRAMENTO, CA

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General NPI Number Information
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    NPI Number           |    1467470252
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    Entity Type          |    Organization 
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    Legal Business Name  |    WALMART INC. 
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Dates
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    Enumeration Date     |    07/18/2006
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    Last Update Date     |    06/12/2025
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Provider Practice Location Address
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    Address Line         |    5821 ANTELOPE RD 
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    City                 |    SACRAMENTO
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    State                |    CA
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    Zip                  |    95842-3902
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    Country              |    US
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    Telephone            |    916-729-6236
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    Fax                  |    916-729-6248
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Provider Business Mailing Address
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    Address Line         |    702 SW 8TH ST 
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    City                 |    BENTONVILLE
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    State                |    AR
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    Zip                  |    72716-0445
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    SENIOR DIRECTOR, ENROLLMENT
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    Name                 |     KIMBERLY  CANONIC 
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    Credential           |    
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    Telephone            |    480-853-0515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    332B00000X
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    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    333600000X
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    Taxonomy Name        |    Pharmacy
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    47502
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    License Number State |    CA
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