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Walmart Inc.

Community/Retail Pharmacy in Fayetteville, AR · enumerated 2010 · authorized official Kimberly Canonic, Senior Director, Enrollment.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1174824395

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Registry record

Entity type Organization (Type 2)
Legal business name Walmart Inc.
Other name <Unavail>
Practice address 616 N Garland Ave Ste 363, Suite 363, Fayetteville, AR, 72701
Phone (479) 443-1658
Fax (479) 443-8038
Enumeration date Nov 4, 2010
Last updated in NPPES Jun 5, 2025

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Secondary
333600000X Pharmacy Suppliers Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License AR20640 (AR) Primary

Authorized official

Name Kimberly Canonic
Title Senior Director, Enrollment
Phone (480) 277-6348

Other identifiers

Identifier Type State Issuer
2127442 Other - PK
1174824395 Medicaid MO -
186892407 Medicaid AR -
100238800A Medicaid OK -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2025-06-05. Verify at npiregistry.cms.hhs.gov.
Where is Walmart Inc. located?
The practice location on file with NPPES is in Fayetteville, AR.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-06-05.