Wal-Mart Stores Texas LLC
NPI 1184032955 · Community/Retail Pharmacy · Ft Worth, TX
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Wal-Mart Stores Texas LLC is a Community/Retail Pharmacy organization in Ft Worth, TX (NPI 1184032955).
Provider details
- NPI number
- 1184032955
- 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
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 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 10-4165
Registry dates
- Enumerated
- 2014-07-24
- Last updated
- 2025-06-06
- Certified
- 2025-06-06
Frequently asked questions
- What is Wal-Mart Stores Texas LLC's NPI number?
- Wal-Mart Stores Texas LLC's National Provider Identifier (NPI) is 1184032955, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Wal-Mart Stores Texas LLC?
- Wal-Mart Stores Texas LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Wal-Mart Stores Texas LLC located?
- Wal-Mart Stores Texas LLC's practice location on file with NPPES is 2245 Jacksboro Hwy, Ft Worth, TX 76114-2319.
- What is Wal-Mart Stores Texas LLC's phone number?
- The practice phone number listed in the NPPES registry for Wal-Mart Stores Texas LLC is (817) 569-6241.
- Does Wal-Mart Stores Texas LLC accept Medicare?
- Wal-Mart Stores Texas LLC 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 Wal-Mart Stores Texas LLC?
- The authorized official listed on Wal-Mart Stores Texas LLC'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 Wal-Mart Stores Texas LLC's NPI active?
- Yes — Wal-Mart Stores Texas LLC's NPI (1184032955) is active in the NPPES registry as of the last update on 2025-06-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.