Walmart Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

260959 Issued in MN

Legal business name

WALMART INC.

Practice address

8000 Lakeland Ave N
Brooklyn Park, MN 55445-2403

Phone

(763) 424-7077

NPI assigned

Jul 16, 2006

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) 853-0515

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• WALMART PHARMACY 10-1864 Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN2 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 East, LP

  • Eyewear Supplier
  • Rochester, MN
  • NPI 1326129511
  NPD tax ID
• Wal-Mart Stores Inc

  • Eyewear Supplier
  • Burnsville, MN
  • NPI 1508116807
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Shakopee, MN
  • NPI 1285715003
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Alexandria, MN
  • NPI 1295819829
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Austin, MN
  • NPI 1336518869
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Albert Lea, MN
  • NPI 1346321148
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Eagan, MN
  • NPI 1376624411
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Owatonna, MN
  • NPI 1437230232
  NPD tax ID
• Wal-Mart Stores, Inc.

  • Eyewear Supplier
  • Hibbing, MN
  • NPI 1447363197
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Park Rapids, MN
  • NPI 1265565394
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Redwood Falls, MN
  • NPI 1275550659
  NPD tax ID
• Walmart Inc.

  • Community/Retail Pharmacy
  • Rochester, MN
  • NPI 1295752798
  NPD tax ID

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1366469744",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 LAKELAND AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554452403",
            "telephone_number": "763-424-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALMART INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "CANONIC",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR, ENROLLMENT",
        "authorized_official_telephone_number": "480-853-0515"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "260959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "479560100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2046929",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "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 10-1864",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wal-Mart Stores, Inc.
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• Walman Optical Company
• Jonale Ward
• Warm Touch Home Care Inc
• Wahnue Washington
• Watchful Caregivers, Inc
• Nikolas Brandon Watkins, MA, LPCC

• Community/Retail Pharmacy in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.