NPI age
9 years
Enumerated 2016-06-01
● Active Type 2 · Organization
Walmart Inc.
Walmart Inc. is 1 of 397 pharmacy organizations in Idaho.
Primary specialty
Pharmacy
Plus 2 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Canonic
Senior Director, Enrollment
Last NPPES update
2025-06-10
Source: monthly bulk 2026-05
How this organization compares
Across 397 active pharmacy providers in Idaho.
NPI age
9 years
↓ 10 yr below median
Practice locations
1
0 secondary on file
Subspecialties
2
In the 70% of peers with subspecialties
NPI lifetime · 2016 → 2026
2016-06Enumerated in NPPES
2016
2026
Where they practice
Primary practice location
622 W Ustick Rd
Caldwell, ID 836056248
Mailing address
702 Sw 8th St
Bentonville, AR 727160445
Authorized official
Kimberly Canonic
Senior Director, Enrollment
📞 4802776348
Specialties
-
Pharmacy PrimaryA pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the...
-
Durable Medical Equipment & Medical SuppliesA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
-
PharmacyA facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 2160484 | PK |
| 05 (ID) | 1093163990 |
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.