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Walmart Inc.

Walmart Inc. is a healthcare organization registered as Community/Retail Pharmacy in Ukiah, CA, holding Type 2 (organization) NPI 1760409098 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.

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NPI 1760409098
Entity type Organization (Type 2)
Legal business name Walmart Inc.
Other name <Unavail>
Practice address 1155 AIRPORT PARK BLVD, Ukiah, CA, 95482
Phone 7074680171
Fax 7074680594
Enumeration date 2006-07-16
Last updated in NPPES 2025-06-05

Authorized official

Name Kimberly Canonic
Title Senior Director, Enrollment
Phone 4802776348

Taxonomy & classification

Taxonomy code Specialty Primary License State
332B00000X Durable Medical Equipment & Medical Supplies Secondary
333600000X Pharmacy Secondary
3336C0003X Community/Retail Pharmacy Primary PHY39659 CA

Other identifiers

Identifier Type State Issuer
463PHA396590 Medicaid CA
2103328 Other PK
Copy-ready billing details
Provider: Walmart Inc.
NPI: 1760409098
Taxonomy: 3336C0003X (Community/Retail Pharmacy)
Address: 1155 AIRPORT PARK BLVD, Ukiah, CA, 95482

Providers at this address

NPI Name Type Specialty Location
1528437183 Thomas Carnegie Individual Pharmacist Ukiah, CA
1528438397 Madiha Khan Individual Pharmacist Ukiah, CA
1033666383 Walmart Organization Pharmacy Ukiah, CA
1013497411 John Chladek Individual Pharmacist Ukiah, CA
1043841679 Dieu Linh Vo Individual Pharmacist Ukiah, CA
1053089805 Thong Le Individual Pharmacist Ukiah, CA
1962165902 Duy Doan Individual Pharmacist Ukiah, CA
1831908029 Jacqueline Breland Individual Pharmacist Ukiah, CA

Verify this record

Cross-check NPI 1760409098 against the authoritative CMS record: view Walmart Inc. on the official NPPES registry .

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. Read the full guide or validate an NPI number.

Frequently asked questions

Where is Walmart Inc. located?
The practice location on file with NPPES is in Ukiah, CA.
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.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-06-05.