NPIMap

Organization Active NPI

Walmart Inc

Doing business as Walmart Pharmacy 10-3089

  • Pharmacy
  • Mesa, AZ
National Provider Identifier
1942108121
Registry record updated Oct 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
WALMART INC
Doing business as
Walmart Pharmacy 10-3089
Practice address
6312 S Mountain Rd
Mesa, AZ 85212
Phone
(602) 606-4195
Fax
(602) 606-4178
NPI assigned
Oct 28, 2026
Last updated
Oct 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kimberly Canonic
Title
Senior Director
Phone
(480) 853-0515

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

6312 S Mountain Rd
Mesa, AZ 85212

Mailing address

1 Customer Dr
Bentonville, AR 72716-0445

Other names 1

  • Walmart Pharmacy 10-3089 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network2,177 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1793145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793145600000",
    "number": "1942108121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CUSTOMER DR",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6312 S MOUNTAIN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85212",
            "telephone_number": "602-606-4195",
            "fax_number": "602-606-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALMART INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-28",
        "last_updated": "2026-10-28",
        "certification_date": "2026-10-26",
        "status": "A",
        "authorized_official_last_name": "CANONIC",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR",
        "authorized_official_telephone_number": "480-853-0515"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walmart Pharmacy 10-3089",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.