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General NPI Number Information
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NPI Number | 1487570511
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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 | 06/24/2026
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Last Update Date | 06/25/2026
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Provider Practice Location Address
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Address Line | 575 SATURN BLVD
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City | SAN DIEGO
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State | CA
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Zip | 92154-4731
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Country | US
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Telephone | 619-205-6145
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Fax | 619-205-6149
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Provider Business Mailing Address
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Address Line | 1 CUSTOMER DR
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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 | 619-205-6145
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Fax | 619-205-6149
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Authorized Official
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Title or Position | SENIOR DIRECTOR, BILLING
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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 | 332H00000X
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Taxonomy Name | Eyewear Supplier
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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