Active NPI
Walmart Inc.
- Community/Retail Pharmacy
- Fresno, CA
National Provider Identifier
1477958478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 52520
- Legal business name
- WALMART INC.
- Practice address
- 3131 N Cedar Ave
Fresno, CA 93703-1532 - Phone
- (559) 538-1376
- Fax
- (559) 538-1377
- NPI assigned
- Nov 3, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | 52520 | CA | Primary |
Addresses
Primary practice location
3131 N Cedar Ave
Fresno, CA 93703-1532
Mailing address
702 SW 8TH St
Bentonville, AR 72716-0445
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2148710 | Other | PK |
Other names 1
- WalMart Pharmacy 10-2689
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140203000875 | CA | Part B Supplier - Mass Immunization (Roster Biller Only) | 4385556745 | This NPI is an additional NPI on the enrollment |
| O20150612001066 | CA | DME Supplier - Pharmacy | 4385556745 | Practice locations: Fresno, CA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2341010 | Walmart Pharmacy #10-2689 | Certificate of waiver | Mar 25, 2028 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Walmart Pharmacy 10-2689 | Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Ostomy Supplies|Enteral Nutrients|Surgical Dressings | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Ability Network
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.
-
- Eyewear Supplier
- Antelope, CA
- NPI 1477656494
-
- Eyewear Supplier
- Sacramento, CA
- NPI 1467974477
-
- Eyewear Supplier
- Long Beach, CA
- NPI 1457756546
-
- Eyewear Supplier
- Ventura, CA
- NPI 1457781049
-
- Eyewear Supplier
- San Bernardino, CA
- NPI 1467536003
-
- Optician
- San Diego, CA
- NPI 1487570511
-
- Community/Retail Pharmacy
- Sacramento, CA
- NPI 1467470252
-
- Community/Retail Pharmacy
- Placerville, CA
- NPI 1467479717
-
- Community/Retail Pharmacy
- Visalia, CA
- NPI 1467727479
-
- Community/Retail Pharmacy
- San Jose, CA
- NPI 1467861112
-
- Community/Retail Pharmacy
- Oceanside, CA
- NPI 1477570729
-
- Community/Retail Pharmacy
- Atwater, CA
- NPI 1477857639
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Student in an Organized Health Care Education/Training Program
- Fresno, CA
- NPI 1356951859
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414972800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758240000000",
"number": "1477958478",
"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": "3131 N CEDAR AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937031532",
"telephone_number": "559-538-1376",
"fax_number": "559-538-1377"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALMART INC.",
"organizational_subpart": "NO",
"enumeration_date": "2014-11-03",
"last_updated": "2025-09-19",
"certification_date": "2023-08-30",
"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": "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": "52520",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2148710",
"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 10-2689",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "WalMart Pharmacy 10-2689",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.