NPI age
12 years
Enumerated 2013-06-06
● 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
2025-06-05
Source: monthly bulk 2026-05
How this organization compares
Across 397 active pharmacy providers in Idaho.
NPI age
12 years
↓ 7 yr below median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 70% of peers with subspecialties
NPI lifetime · 2013 → 2026
2013-06Enumerated in NPPES
2013
2026
Where they practice
Primary practice location
795 W Overland Rd
Meridian, ID 836426556
Mailing address
702 Sw 8th St
Bentonville, AR 727160445
Authorized official
Kimberly Canonic
Senior Director, Enrollment
📞 4802776348
Individual providers at this organization
6 individual providers on file at this primary practice address.
- Mary Gibson Pharmacist NPI 1881288462
- Lolettima Johnson, PHARM.D. Pharmacist NPI 1740730852
- Scott Johnson Pharmacist NPI 1134537566
- Marcus Michaelis, PHARMD Pharmacist NPI 1891330551
- Jason Sandy, PHARM.D. Pharmacist NPI 1376950568
- Samuel Weatherspoon Pharmacist NPI 1679974042
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 |
|---|---|---|
| 01 | 2140844 | PK |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
WalMart Pharmacy 10-3093
Practice context
Multi-provider organization. 6 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.