Walmart Inc.
NPI 1174824395 · Community/Retail Pharmacy · Fayetteville, AR
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Walmart Inc. is a Community/Retail Pharmacy organization in Fayetteville, AR (NPI 1174824395).
Provider details
- NPI number
- 1174824395
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Kimberly Canonic, Senior Director, Enrollment(480) 277-6348
Specialties & taxonomies
Suppliers
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 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
Mailing address
Other names (DBA / former)
- Doing business as
- Walmart Pharmacy 10-2997
Registry dates
- Enumerated
- 2010-11-04
- Last updated
- 2025-06-05
- Certified
- 2025-06-05
Frequently asked questions
- What is Walmart Inc.'s NPI number?
- Walmart Inc.'s National Provider Identifier (NPI) is 1174824395, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Walmart Inc.?
- Walmart Inc. is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Walmart Inc. located?
- Walmart Inc.'s practice location on file with NPPES is 616 N Garland Ave Ste 363, Fayetteville, AR 72701-3116.
- What is Walmart Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Walmart Inc. is (479) 443-1658.
- Does Walmart Inc. accept Medicare?
- Walmart Inc. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Walmart Inc.?
- The authorized official listed on Walmart Inc.'s NPPES record is Kimberly Canonic, Senior Director, Enrollment. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Walmart Inc.'s NPI active?
- Yes — Walmart Inc.'s NPI (1174824395) is active in the NPPES registry as of the last update on 2025-06-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.