Organization · Type 2 NPI

Wal-Mart Puerto Rico Inc

Community/Retail Pharmacy · Canovanas, PR

NPI number 1194988709 Active

Practice location

Plaza Canovanas Hwy 3 Int New Rt 66
Canovanas, PR 00729

Call (787) 957-2715 Map

Mailing address

1 Customer Dr, Ms 0445
Bentonville, AR 72716-6209

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	18-P-2535 (PR)

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

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NPI record

NPI: 1194988709
Entity type: Organization (Type 2)
Issued: Jul 3, 2008
Last updated: Jul 17, 2026
Status: Active

Other names

<unavail>
Walmart Pharmacy 10-5802 · doing business as
Walmart Pharmacy 10-5802 · doing business as

Authorized official

Kimberly Canonic
Senior Director, Enrollment
(480) 277-6348

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1194988709

Wal-Mart Puerto Rico Inc's National Provider Identifier is 1194988709, issued on Jul 3, 2008. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Canovanas, PR. The record was last updated on Jul 17, 2026.