Walmart Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

53455 Issued in CA

Legal business name

WALMART INC.

Practice address

8915 Gerber Rd
Sacramento, CA 95829-1155

Phone

(916) 897-5010

Fax

(916) 897-5015

NPI assigned

Mar 12, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kimberly Canonic

Title

Senior Director, Enrollment

Phone

(480) 277-6348

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Walmart Pharmacy 10-3081 Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Tax ID family

Ability Network2,173 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Wal Mart Stores, Inc. Dba Wal-Mart

  • Eyewear Supplier
  • Cerrito, CA
  • NPI 1265527261
  NPD tax ID
• Wal Mart Stores, Inc. Dba Wal-Mart

  • Eyewear Supplier
  • Paso Robles, CA
  • NPI 1295822161
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Rohnert Park, CA
  • NPI 1255417663
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Long Beach, CA
  • NPI 1265513303
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Rohnert Park, CA
  • NPI 1255740874
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Simi Valley, CA
  • NPI 1255764775
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • San Marcos, CA
  • NPI 1265459499
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Thousand Oaks, CA
  • NPI 1265857585
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Escondido, CA
  • NPI 1265864078
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Fremont, CA
  • NPI 1275550410
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Anaheim, CA
  • NPI 1275898553
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Torrance, CA
  • NPI 1275898637
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cindy Ka Dyer, PHARM.D.

  • Pharmacist
  • Sacramento, CA
  • NPI 1295092294
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1275926446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160445",
            "telephone_number": "479-258-2115",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8915 GERBER RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958291155",
            "telephone_number": "916-897-5010",
            "fax_number": "916-897-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALMART INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-12",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "CANONIC",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR, ENROLLMENT",
        "authorized_official_telephone_number": "480-277-6348"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "53455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275926446",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2151435",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.22.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Walmart Pharmacy 10-3081",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walmart Pharmacy 10-3081",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Candace Shante Walls
• Julayah Almonae Walls
• Merissa Walls, DO
• Walmart
• Walmart Inc.
• Walmart Inc.
• Walmart Inc.
• Walmart Inc.
• Walmart Inc.
• Walmart Stores, Inc.

• Community/Retail Pharmacy in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.