Walmart INC.
Pharmacy, Community/Retail Pharmacy in Victorville, CA. Organization (NPI-2).
NPI number1043237456
StatusActive
Last updated in NPPESJul 14, 2025
Details
- NPI
- 1043237456
- Entity type
- Organization (NPI-2)
- Legal business name
- Walmart INC.
- Organization subpart
- No
- Enumeration date
- Jul 16, 2006
- Certification date
- Jul 14, 2025
- Last updated
- Jul 14, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | PHY36937 | CA | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 333600000X | Pharmacy | – | – |
Other names
- Walmart Pharmacy 10-1588 (Doing Business As)
Practice location
11896 Amargosa RdVictorville, CA 92392-8133
Phone 760-951-5188 · Fax 760-951-5208
Mailing address
702 Sw 8th StMail Stop 0445
Bentonville, AR 72716-0445
Phone 479-277-1242
Authorized official
Kimberly Canonic
Senior Director, Enrollment
4802776348
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All 27 Community/Retail Pharmacy providers in Victorville · All 3,391 providers in Victorville
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