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NPI Code Detail

MEDICARE: WALMART INC.

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
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0003XCommunity/Retail PharmacyPHARCF60102610WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22110431OTHERPK

General Provider Information

NPI Number : 1639196751
Entity Type Code : Organization
Provider Name (Legal Business Name) : WALMART INC.
Provider Business Mailing Address
First Line : 702 SW 8TH STREET
Second Line :
City : BENTONVILLE
State : AR
Zip : 72716-0445
Country : US
Telephone Number : 479-258-2115
Fax Number :
Provider Business Practice Location Address
First Line : 2301 FREEWAY DR
Second Line :
City : MOUNT VERNON
State : WA
Zip : 98273-5445
Country : US
Telephone Number : 360-428-3911
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF HEALTHCARE CONTRACTING
Name : SARAH LITTLE
Credential :
Telephone Number : 479-277-2500
Provider Enumeration Date : 07/16/2006
Last Update Date : 09/19/2025

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Directions to “WALMART INC. ” Practice Location

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