OrganizationActive
Walmart Inc.
NPI 1053338103 · Community/Retail Pharmacy · Portland, OR
Provider details
- NPI number
- 1053338103
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Sarah Little, Director of Healthcare Contracting(479) 277-2500
Specialties & taxonomies
Suppliers
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4200 Se 82nd Ave
Portland, OR 97266-2943
Phone: (503) 788-0400
Street-level locationGet directions
Mailing address
702 Sw 8th Street
Bentonville, AR 72716-0445
Other names (DBA / former)
- Doing business as
- Walmart Pharmacy 10-2552
Registry dates
- Enumerated
- 2006-07-16
- Last updated
- 2025-09-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.