MEDICARE: WALMART INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy	1680000092	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2152011	OTHER		PK

General Provider Information

NPI Number	:	1528455953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALMART INC.

Provider Business Mailing Address
First Line	:	702 SW 8TH ST
Second Line	:
City	:	BENTONVILLE
State	:	AR
Zip	:	72716-0445
Country	:	US
Telephone Number	:	479-258-2115
Fax Number	:	479-277-4331

Provider Business Practice Location Address
First Line	:	4425 VENETUCCI BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4013
Country	:	US
Telephone Number	:	719-313-4385
Fax Number	:	719-313-4379

Authorized Official
Title or Position	:	DIRECTOR OF HEALTHCARE CONTRACTING
Name	:	SARAH LITTLE
Credential	:
Telephone Number	:	479-277-2500

Provider Enumeration Date	:	04/23/2015
Last Update Date	:	09/19/2025

Similar Medicare Providers

1811550098 — DR. ERIC SULLIVAN PHARM.D
Practice Location Address:

4425 VENETUCCI BLVD
COLORADO SPRINGS, CO
80906-4013

Practice Phone: 719-313-4385
Practice Fax: 719-313-4379

1770146474 — MIGUEL CARABALLO PHARMD
Practice Location Address:

4425 VENETUCCI BLVD
COLORADO SPRINGS, CO
80906-4013

Practice Phone: 719-313-4385
Practice Fax:

1043821861 — VALOR VISION CLINIC LLC
Practice Location Address:

4425 VENETUCCI BLVD
COLORADO SPRINGS, CO
80906-4013

Practice Phone: 719-306-1347
Practice Fax:

1881134963 — SOUTHERN COLORADO FAMILY EYE CARE, PC
Practice Location Address:

4425 VENETUCCI BLVD
FOUNTAIN, CO
80906-4013

Practice Phone: 719-576-1049
Practice Fax:

1699924290 — MICHAEL C MOORE M.D. P. C.
Practice Location Address:

7055 JUNIPER DR
COLORADO SPRINGS, CO
80908-4013

Practice Phone: 719-495-2175
Practice Fax:

1508336942 — KATHERINE DUGGLEBY LCSW
Practice Location Address:

117 W RIO GRANDE ST
COLORADO SPRINGS, CO
80903-4013

Practice Phone: 719-632-5700
Practice Fax:

Directions to “WALMART INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.