DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
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 PharmacyCF0005314WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22110249OTHERPK

General Provider Information

NPI Number : 1649297763
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 :
Fax Number :
Provider Business Practice Location Address
First Line : 3497 BETHEL RD SE
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-5634
Country : US
Telephone Number : 360-874-9063
Fax Number :
Authorized Official
Title or Position : SENIOR DIRECTOR, ENROLLMENT
Name : KIMBERLY CANONIC
Credential :
Telephone Number : 480-277-6348
Provider Enumeration Date : 07/16/2006
Last Update Date : 05/27/2025

Similar Medicare Providers

1366721029 — WAL-MART STORES INC
Practice Location Address:
3497 BETHEL RD SE
PORT ORCHARD, WA
98366-5634
Practice Phone: 360-874-9060
Practice Fax:
1184033029 — MILA CORPUZ
Practice Location Address:
3497 BETHEL RD SE
PORT ORCHARD, WA
98366-5634
Practice Phone: 360-874-9063
Practice Fax:
1669871869 — WALMART
Practice Location Address:
3497 BETHEL RD SE
PORT ORCHARD, WA
98366-5634
Practice Phone: 360-874-9063
Practice Fax: 360-874-0071
1760888051 — MICAJAH JENKINS
Practice Location Address:
3497 BETHEL RD SE
PORT ORCHARD, WA
98366-5634
Practice Phone: 360-874-9063
Practice Fax: 360-874-0071
1417481805 — PRAJAKTA PALKAR ALBRECHT RPH
Practice Location Address:
3497 BETHEL RD SE
PORT ORCHARD, WA
98366-5634
Practice Phone: 360-874-9063
Practice Fax:
1073483236 — DR. TALIA JAE MOORE PHARMD
Practice Location Address:
3497 BETHEL RD SE
PORT ORCHARD, WA
98366-5634
Practice Phone: 360-874-9063
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 © 2007-2025 (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.