NPI 1104844612

Walmart INC.

Organisation Community/Retail Pharmacy Glen Ellyn, IL

Practice location

Address: 3s100 Il Route 53, Glen Ellyn, IL 60137-7394
Phone: (630) 545-1080
Mailing address: 702 SW 8th St, Bentonville, AR 72716-0445

Authorised official

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

Registered specialties (3)

Community/Retail Pharmacy Primary

Suppliers Taxonomy 3336C0003X Licence 054011491 (IL)

Other Pharmacy providers in Illinois →

Durable Medical Equipment & Medical Supplies

Suppliers Taxonomy 332B00000X

Other Durable Medical Equipment & Medical Supplies providers in Illinois →

Pharmacy

Suppliers Taxonomy 333600000X

Registry record

NPI: 1104844612
Entity type: Organization
NPI issued: 17 Jul 2006
Record last updated: 16 Jun 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.