Active NPI
Walmart Inc.
- Community/Retail Pharmacy
- Chicago, IL
National Provider Identifier
1326382102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 320.010457
- Legal business name
- WALMART INC.
- Practice address
- 2551 W Cermak Rd
Chicago, IL 60608-3719 - Phone
- (773) 475-4209
- NPI assigned
- Nov 19, 2012
- Last updated
- Feb 28, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sarah Little
- Title
- Director of Healthcare Contracting
- Phone
- (479) 277-2500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 320.010457 | IL | Primary |
Addresses
Primary practice location
2551 W Cermak Rd
Chicago, IL 60608-3719
Mailing address
702 SW 8TH St
Bentonville, AR 72716-0445
Phone (479) 204-0709
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2138048 | Other | PK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130814000649 | IL | Part B Supplier - Mass Immunization (Roster Biller Only) | 4385556745 | This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353283200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1519776000000",
"number": "1326382102",
"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": "479-204-0709",
"fax_number": "479-277-4331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2551 W CERMAK RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606083719",
"telephone_number": "773-475-4209"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALMART INC.",
"organizational_subpart": "NO",
"enumeration_date": "2012-11-19",
"last_updated": "2018-02-28",
"status": "A",
"authorized_official_last_name": "LITTLE",
"authorized_official_first_name": "SARAH",
"authorized_official_title_or_position": "DIRECTOR OF HEALTHCARE CONTRACTING",
"authorized_official_telephone_number": "479-277-2500"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "IL",
"license": "320.010457",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2138048",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.