What is Wal-Mart Stores Texas LLC's NPI number?

Wal-Mart Stores Texas LLC's National Provider Identifier (NPI) is 1184641359, 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 800 W Gibson St, Jasper, TX 75951-4914.

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 (409) 384-7108.

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 (1184641359) is active in the NPPES registry as of the last update on 2025-05-29.

OrganizationActiveAccepts Medicare

Wal-Mart Stores Texas LLC

NPI 1184641359 · Community/Retail Pharmacy · Jasper, TX

Wal-Mart Stores Texas LLC is a Community/Retail Pharmacy organization in Jasper, TX (NPI 1184641359).

Provider details

NPI number: 1184641359
Entity type: Organization
Primary specialty: Community/Retail PharmacySuppliers
Organization subpart: No
Authorized official: Kimberly Canonic, Senior Director, Enrollment(480) 277-6348

Practice location

800 W Gibson St

Jasper, TX 75951-4914

Phone: (409) 384-7108

Street-level locationGet directions

More TX providers

Mailing address

702 Sw 8th St

Bentonville, AR 72716-0445

Specialties & taxonomies

Community/Retail PharmacyPrimary3336C0003XLicense 21769 (TX)
Suppliers
Durable Medical Equipment & Medical Supplies332B00000X
Suppliers
Pharmacy333600000X
Suppliers

Other names (DBA / former)

Doing business as: Walmart Pharmacy 10-0214
Doing business as: Walmart Pharmacy 10-0214

Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)

Profile Score

Detailed profile(80/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure28% of score
20 yrs in NPPES registry
Profile completeness28% of score
100% of core fields populated
Practice footprint17% of score
1 documented practice location
Medicare service volume (vs. specialty peers)28% of score
349 Medicare services, 2024 (ranked within specialty)

Medicare volume is ranked against active providers in the same specialty. 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.

What this provider does (Medicare)

Based on Medicare fee-for-service claims, 2024; not all care is captured.

Service (HCPCS)	Medicare services	Typical Medicare-allowed (2024)
Administration of Influenza Virus VaccineG0008	217	$21
Admn Sarscov2 Vacc 1 Dose90480	99	$10
Administration of Pneumococcal VaccineG0009	33	$16

Typical Medicare-allowed amounts for these services range $10–$21 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.

Enumerated: 2006-07-16
Last updated: 2025-05-29
Certified: 2025-05-29

Frequently asked questions

What is Wal-Mart Stores Texas LLC's NPI number?: Wal-Mart Stores Texas LLC's National Provider Identifier (NPI) is 1184641359, 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 800 W Gibson St, Jasper, TX 75951-4914.
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 (409) 384-7108.
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 (1184641359) is active in the NPPES registry as of the last update on 2025-05-29.

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Provider details

Practice location

Mailing address

Specialties & taxonomies

Other names (DBA / former)

Profile Score

What this provider does (Medicare)

Registry dates

Frequently asked questions

Specialties & taxonomies

Other names (DBA / former)

Frequently asked questions

Profile Score

What this provider does (Medicare)