Active NPI
Walmart Inc.
- Community/Retail Pharmacy
- Oskaloosa, IA
National Provider Identifier
1578580072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 552
- Legal business name
- WALMART INC.
- Doing business as
- WALMART PHARMACY 10-1393
- Practice address
- 2203 A Ave W
Oskaloosa, IA 52577-1965 - Phone
- (641) 673-6811
- NPI assigned
- Jul 17, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 552 | IA | Primary |
Addresses
Primary practice location
2203 A Ave W
Oskaloosa, IA 52577-1965
Mailing address
702 SW 8TH St
Bentonville, AR 72716-0445
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2028382 | Other | PK | |
| 0285338 | Medicaid | IA | |
| 285338 | Medicaid | IA |
Other names 1
- WALMART PHARMACY 10-1393
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 IA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930088598 | IA | DME Supplier - Pharmacy | 4385556745 | Practice locations: Oskaloosa, IA |
| O20131029001699 | IA | Part B Supplier - Mass Immunization (Roster Biller Only) | 4385556745 | This NPI is an additional NPI on the enrollment |
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 |
|---|---|---|---|
| 16D2144444 | Walmart Pharmacy 10-1393 | Certificate of waiver | Feb 15, 2028 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Wal-Mart Pharmacy 10-1393 | 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|Prosthetic Lenses: Conventional Eyeglasses|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
- Indianola, IA
- NPI 1386725471
-
- Eyewear Supplier
- Sioux City, IA
- NPI 1396826483
-
- Eyewear Supplier
- Ottumwa, IA
- NPI 1467535732
-
- Eyewear Supplier
- West Des Moines, IA
- NPI 1528149325
-
- Eyewear Supplier
- Knoxville, IA
- NPI 1558444190
-
- Eyewear Supplier
- Sioux City, IA
- NPI 1578644571
-
- Eyewear Supplier
- West Burlington, IA
- NPI 1588747125
-
- Eyewear Supplier
- Des Moines, IA
- NPI 1619058419
-
- Eyewear Supplier
- Council Bluffs, IA
- NPI 1619058872
-
- Eyewear Supplier
- Clinton, IA
- NPI 1639250749
-
- Community/Retail Pharmacy
- Cedar Falls, IA
- NPI 1386661775
-
- Community/Retail Pharmacy
- Centerville, IA
- NPI 1467479840
Locations
1714 3rd Ave E
Oskaloosa, IA 52577
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758240000000",
"number": "1578580072",
"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": "2203 A AVE W",
"city": "OSKALOOSA",
"state": "IA",
"postal_code": "525771965",
"telephone_number": "641-673-6811"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALMART INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-17",
"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": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "IA",
"license": "552",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2028382",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0285338",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "285338",
"state": "IA"
}
],
"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 10-1393",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Oskaloosa, IA
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.