Walmart Inc.
Walmart Inc. is a healthcare organization registered as Community/Retail Pharmacy in Coos Bay, OR, holding Type 2 (organization) NPI 1861419905 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1861419905 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Walmart Inc. |
| Other name | <Unavail> |
| Practice address | 2051 NEWMARK AVE, Coos Bay, OR, 97420 |
| Phone | 5418885750 |
| Enumeration date | 2006-07-16 |
| Last updated in NPPES | 2025-06-12 |
Authorized official
| Name | Kimberly Canonic |
|---|---|
| Title | Senior Director, Enrollment |
| Phone | 4808530515 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 333600000X | Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 0001274CS | OR |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52873 | Medicaid | OR | — |
| 052873 | Medicaid | OR | — |
| 2078281 | Other | — | PK |
Copy-ready billing details
Provider: Walmart Inc. NPI: 1861419905 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 2051 NEWMARK AVE, Coos Bay, OR, 97420
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1790723740 | National Vision, Inc. | Organization | Eyewear Supplier | Coos Bay, OR |
| 1245427939 | Gary Kitzrow | Individual | Optometrist | Coos Bay, OR |
| 1740592930 | David Zelman | Individual | Pharmacotherapy Pharmacist | Coos Bay, OR |
| 1639587512 | David Petley | Individual | Pharmacist | Coos Bay, OR |
| 1396129565 | Joseph Abraham | Individual | Pharmacist | Coos Bay, OR |
| 1598149759 | Asadullah Obaidi | Individual | Pharmacist | Coos Bay, OR |
| 1760853253 | Gregory Carver | Individual | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | Coos Bay, OR |
| 1164949327 | Nina Yu | Individual | Pharmacist | Coos Bay, OR |
Verify this record
Cross-check NPI 1861419905 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
How current is this record?
Where is Walmart Inc. located?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-06-12.