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 PharmacyPHY44553CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22066298OTHERPK

General Provider Information

NPI Number : 1770500092
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 :
Fax Number :
Provider Business Practice Location Address
First Line : 19821 RINALDI ST
Second Line :
City : PORTER RANCH
State : CA
Zip : 91326-4145
Country : US
Telephone Number : 818-832-6592
Fax Number : 818-832-1263
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

Similar Medicare Providers

1891740494 — NATIONAL VISION, INC.
Practice Location Address:
19821 RINALDI ST
PORTER RANCH, CA
91326-4145
Practice Phone: 818-832-0784
Practice Fax:
1710167085 — FIRSTSIGHT VISION SERVICES, INC.
Practice Location Address:
19821 RINALDI ST
PORTER RANCH, CA
91326-4145
Practice Phone: 818-832-1493
Practice Fax: 818-832-5056
1407249493 — MAGGIE LA RPH
Practice Location Address:
19821 RINALDI ST
PORTER RANCH, CA
91326-4145
Practice Phone: 818-832-6592
Practice Fax:
1942694633 — RENEE MARQUEDANT
Practice Location Address:
19821 RINALDI ST
PORTER RANCH, CA
91326-4145
Practice Phone: 818-832-6592
Practice Fax:
1073021887 — MELBA MANALANG SALES
Practice Location Address:
19821 RINALDI ST
PORTER RANCH, CA
91326-4145
Practice Phone: 818-363-4067
Practice Fax:
1831688225 — BERNARD GOROSPE RPH
Practice Location Address:
19821 RINALDI ST
PORTER RANCH, CA
91326-4145
Practice Phone: 818-832-6592
Practice Fax: 818-832-6073

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.