WALMART INC. (NPI# 1174540421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174540421 |
| Entity Type | Organization |
| Organization Name | WALMART INC. |
| Other Organization Name | WALMART PHARMACY 10-2780 |
| Practice Address |
5108 Cleveland Blvd Caldwell ID 83607-8002 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 2084550800 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING) |
| Authorized Official Telephone | 4792772500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
1528RP | ID | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 805854400 | 05 | |
| ID | 80584400 | 05 | |
| PK | 2021741 | 01 |
| Other Name | Type Code |
|---|---|
| WALMART PHARMACY 10-2780 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336661461 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 8270 Delta Shores Cir S, Sacramento, CA 95832-9101 | 2017-07-11 |
| 1710407895 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 6973 Blue Diamond Rd, Las Vegas, NV 89178-9213 | 2017-06-21 |
| 1295265072 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 44100 Jefferson St Ste F, Indio, CA 92201-2715 | 2017-06-14 |
| 1528594983 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 898 S 2550 E, Spanish Fork, UT 84660 | 2017-05-04 |
| 1922533082 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 9600 N Metro Pkwy W, Phoenix, AZ 85051-1402 | 2017-04-26 |
| 1730612425 | Walmart Inc. | Pharmacy | 9400 Ralston Rd, Arvada, CO 80002-2004 | 2017-04-10 |
| 1730628728 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 5210 S Highway 95, Fort Mohave, AZ 86426-9223 | 2017-02-23 |
| 1881132926 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 875 E H St, Chula Vista, CA 91910-7807 | 2017-02-09 |
| 1104364157 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 831 E Fort Lowell Rd, Tucson, AZ 85719-2109 | 2017-02-09 |
| 1588109797 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 5320 10th Ave S, Great Falls, MT 59405-5633 | 2016-12-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | WALMART INC | 708 Sw 8th Street, Bentonville, AR 72716 |
| Colorado Business Entities | Walmart Inc. | 708 Sw 8th Street, Bentonville, AR 72716 |
| Oregon Corporations, Companies and Business Names | WALMART INC. | 708 Sw 8th Street, Bentonville, AR 72716 |
| Iowa Business Entities | WALMART INC. | 708 Sw 8th Street, Bentonville, AR 72716 |
| New York State Corporations | WALMART INC. | 28 Liberty Street, New York, New York 10005 |
| Virginia Business Entities | Walmart Inc. | 702 Sw 8th St, Bentonville, Arkansas 72716-6209 |
| Street Address |
5108 CLEVELAND BLVD |
| City | CALDWELL |
| State | ID |
| Zip Code | 83607-8002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285035113 | John E Letter IIi | Pharmacist | 5108 Cleveland Blvd, Caldwell, ID 83607-8002 | 2014-09-10 |
| 1497164263 | Bonnie Brannock-simonson | Pharmacist | 5108 Cleveland Blvd, Caldwell, ID 83607-8002 | 2014-08-06 |
| 1669889853 | Luke Michael Houston | Pharmacist | 5108 Cleveland Blvd, Caldwell, ID 83607-8002 | 2014-07-19 |
| 1245420926 | Kevin Cotter Odpa | Optometrist | 5108 Cleveland Blvd, Caldwell, ID 83607-8002 | 2007-07-27 |
| 1326138322 | Wal-mart Stores, Inc | Eyewear Supplier (Equipment, not the service) | 5108 Cleveland Blvd, Caldwell, ID 83607-8002 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609106012 | Cordell Denton Nebeker | Dentist | 4111 Clocktower Ave., Caldwell, ID 83607 | 2010-01-07 |
| 1265677587 | Cory Shane Lindstrom | Chiropractor | 5216 E. Cleveland Blvd, Ste G, Caldwell, ID 83607 | 2008-12-16 |
| 1154533727 | Reality Based Services | Case Management | 24151 El Paso Rd, Caldwell, ID 83607 | 2007-05-04 |
| 1407998271 | Patrick L Waite | Dentist | 4101 Clock Tower Ave, Caldwell, ID 83607 | 2007-02-12 |
| 1104276377 | Jae's Transportaion LLC | Non-emergency Medical Transport (VAN) | 14310 Tara St, Caldwell, ID 83607-1431 | 2016-06-17 |
| 1417224460 | Rebecca Anne Tormey | Physical Therapist | 1202 Talon Ct, Caldwell, ID 83607-1579 | 2011-11-18 |
| 1174677603 | Vallivue School District #139 | Local Education Agency (LEA) | 5207 S Montana Ave, Caldwell, ID 83607-1583 | 2007-01-22 |
| 1679026447 | Kimberly Drewrey, Aprn, Np-c | Point of Service | 5210 Cleveland Blvd, Suite 140 #344, Caldwell, ID 83607-1796 | 2016-07-28 |
| 1619007903 | Mandy R Redmond | Specialist/Technologist | 1407 E Homedale Rd, Caldwell, ID 83607-1848 | 2007-03-06 |
| 1326263179 | Kira Ann Skroh | Specialist/Technologist | 1407 E Homedale Rd, Caldwell, ID 83607-1848 | 2007-04-16 |
| Find all providers in zip 83607 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | 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 health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194825547 | Brookshire Brothers Inc | Pharmacy | 455 Hwy 36 N, Caldwell, TX 77836 | 2006-09-25 |
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| 1043838584 | Costco Wholesale Corporation | Pharmacy | 3403 W Chinden Blvd, Meridian, ID 83646-7151 | 2020-07-10 |
| 1265054324 | Costco Wholesale Corporation | Pharmacy | 2495 E Lincoln Rd, Idaho Falls, ID 83401-2203 | 2020-05-12 |
| 1851923544 | Rocky Mountain Pharmacy, LLC | Pharmacy | 3910 Washington Pkwy Ste A, Idaho Falls, ID 83404-7884 | 2020-02-10 |
| 1013559269 | Timberline Pharmacy | Pharmacy | 4574 N Ten Mile Rd Ste 110, Meridian, ID 83646-6930 | 2019-10-09 |
| 1508420373 | K2red LLC | Pharmacy | 447 N Idaho St, Wendell, ID 83355 | 2019-04-27 |
| 1679039135 | Hollis Family Pharmacy LLC | Pharmacy | 845 S Substation Rd, Emmett, ID 83617 | 2019-02-20 |
| 1598229809 | Clearwater Canyon Pharmacy, LLC | Pharmacy | 13020 Us-12, Orofino, ID 83544 | 2019-01-31 |
| 1861999377 | Bi-mart Corporation | Pharmacy | 11347 W State Street, Star, ID 83669 | 2018-04-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.