Active NPI
Walmart Inc.
Doing business as WalMart Pharmacy 10-5601
- Community/Retail Pharmacy
- Huntington Beach, CA
National Provider Identifier
1982965414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY50991
- Legal business name
- WALMART INC.
- Doing business as
- WalMart Pharmacy 10-5601
- Practice address
- 21132 Beach Blvd
Huntington Beach, CA 92648-5404 - Phone
- (714) 274-4499
- Fax
- (714) 274-4485
- NPI assigned
- May 31, 2012
- Last updated
- Sep 19, 2025
- 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 | PHY50991 | CA | Primary |
Addresses
Primary practice location
21132 Beach Blvd
Huntington Beach, CA 92648-5404
Mailing address
702 SW 8TH St
Bentonville, AR 72716-6209
Phone (479) 277-1238
Other names 1
- WalMart Pharmacy 10-5601
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 |
|---|---|---|---|---|
| O20131213000251 | CA | DME Supplier - Pharmacy | 4385556745 | Practice locations: Huntington Beach, 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 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 |
|---|---|---|---|
| 05D2342945 | Walmart Pharmacy #10-5601 | Certificate of waiver | Apr 28, 2028 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Walmart Pharmacy 10-5601 | 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 16
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Walmart Pharmacy 10-2077
- Community/Retail Pharmacy
- Lake Elsinore, CA
- NPI 1972520385
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338422400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758240000000",
"number": "1982965414",
"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": "727166209",
"telephone_number": "479-277-1238",
"fax_number": "479-277-4331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21132 BEACH BLVD",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926485404",
"telephone_number": "714-274-4499",
"fax_number": "714-274-4485"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALMART INC.",
"organizational_subpart": "NO",
"enumeration_date": "2012-05-31",
"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": "PHY50991",
"primary": true
}
],
"identifiers": [],
"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 10-5601",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "WalMart Pharmacy 10-5601",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Huntington Beach, 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.