Walmart Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

56792621703 Issued in UT

Legal business name

WALMART INC.

Practice address

350 W Hope Ave
Salt Lake City, UT 84115-5116

Phone

(801) 484-7362

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) 277-6348

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT2 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.

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 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Wal-Mart Stores, Inc

  • Optician
  • Ephraim, UT
  • NPI 1730263054
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • Salt Lake City, UT
  • NPI 1740361781
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • Payson, UT
  • NPI 1811078850
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • Midvale, UT
  • NPI 1831286434
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • South Jordan, UT
  • NPI 1841380821
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • Tooele, UT
  • NPI 1912096405
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • Springville, UT
  • NPI 1912096959
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • Riverdale, UT
  • NPI 1912099847
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • West Valley City, UT
  • NPI 1922189968
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • South Jordan, UT
  • NPI 1932570348
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • St George, UT
  • NPI 1962592204
  NPD tax ID
• Wal-Mart Stores, Inc

  • Eyewear Supplier
  • Clinton, UT
  • NPI 1992886931
  NPD tax ID

Locations

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1851318042",
    "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": "479-277-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W HOPE AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841155116",
            "telephone_number": "801-484-7362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALMART INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A",
        "authorized_official_last_name": "CANONIC",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR, ENROLLMENT",
        "authorized_official_telephone_number": "480-277-6348"
    },
    "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": "UT",
            "license": "56792621703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2100756",
            "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": []
}

• Michael C. Wallis, M.D.
• Cheyenne Wallowingbull
• Sharon T. Walls, LMFT
• Walmart Inc.
• Walmart Inc.
• Melissa Walred
• Andrea Walsh, MS, RDN
• Cheryl Ann Walsh, RN BSN
• David Walsh
• Donna Byrnes Walsh, NP

• Community/Retail Pharmacy in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Community/Retail Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.