NPIMap

Organization Active NPI

Walmart Inc.

Doing business as Walmart Pharmacy 10-5032

  • Community/Retail Pharmacy
  • Buena Park, CA
National Provider Identifier
1750308011
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY46313 Issued in CA
Legal business name
WALMART INC.
Doing business as
Walmart Pharmacy 10-5032
Practice address
8450 La Palma Ave
Buena Park, CA 90620-3210
Phone
(714) 484-3555
Fax
(714) 484-2896
NPI assigned
Jul 16, 2006
Last updated
Sep 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X PHY46313 CA Primary

Addresses

Primary practice location

8450 La Palma Ave
Buena Park, CA 90620-3210

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0445
Phone (479) 204-8550

Other identifiers 2

IdentifierTypeStateIssuer
463PHA463130MedicaidCA
1999388OtherPK

Other names 1

  • Walmart Pharmacy 10-5032 Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
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 CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930029259 CA DME Supplier - PharmacyDME Supplier - Optician 4385556745 Practice locations: Buena Park, CA
O20140203000875 CA Part B Supplier - Mass Immunization (Roster Biller Only) 4385556745 This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2341005Walmart Pharmacy #10-50328450 La Palma Ave, Buena Park, CA 90620Certificate of waiverMar 25, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Walmart Pharmacy 10-50328450 La Palma Ave, Buena Park, CA 90620-3210(714) 484-3555 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 assignmentParticipating since Jan 1, 2019

National Provider Directory

National Provider Directory
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.

View all 24

Locations

8450 La Palma Ave
Buena Park, CA 90620
Phone (714) 484-3555

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1750308011",
    "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": "479-204-8550",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8450 LA PALMA AVE",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906203210",
            "telephone_number": "714-484-3555",
            "fax_number": "714-484-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALMART INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY46313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "463PHA463130",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1999388",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St # A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Walmart Pharmacy 10-5032",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walmart Pharmacy 10-5032",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buena Park, 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.

Verify at the official NPI Registry.