NPI age
19 years
Enumerated 2006-10-03
● Active Type 2 · Organization
Walmart Inc.
Walmart Inc. is 1 of 397 pharmacy organizations in Idaho.
Primary specialty
Pharmacy
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Canonic
Senior Director, Enrollment
Last NPPES update
2025-07-08
Source: monthly bulk 2026-05
How this organization compares
Across 397 active pharmacy providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
1
In the 70% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-10Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
5875 E Franklin Rd
Nampa, ID 836875020
Mailing address
702 Sw 8th St
Bentonville, AR 727160445
Authorized official
Kimberly Canonic
Senior Director, Enrollment
📞 4808530515
Individual providers at this organization
7 individual providers on file at this primary practice address.
- Kathleen Bingham, PHARM D Pharmacist NPI 1144638644
- Jeffrey Buckingham Pharmacist NPI 1992112189
- Kimberly Crowhorn, PHARM. D Pharmacist NPI 1306254040
- Mike Hynes Pharmacist NPI 1982012852
- Jacalyn Iliff, PHARMD Pharmacist NPI 1992091649
- Vijay Sathappan, PHARMD Pharmacist NPI 1295518017
- Anne Warner Pharmacist NPI 1881475408
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.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 907635300 | |
| 05 (ID) | 807635300 | |
| 01 | 2021943 | PK |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Walmart Pharmacy 10-3739
Practice context
Multi-provider organization. 7 individual providers on file at this primary address.
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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.