Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Walmart Inc

Organization Durable Medical Equipment & Medical Supplies · NPI 1700803061

Walmart Inc is a Durable Medical Equipment & Medical Supplies in Vandalia, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

201 Mattes Ave
Vandalia, IL 62471-2063
Phone: (618) 283-0440
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 054008975 (IL)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1700803061
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Canonic — Senior Director, Enrollment · (479) 277-1242
NPI enumeratedJuly 16, 2006
Last updated in NPPESMay 30, 2025
Certification dateMay 30, 2025
Mailing address702 Sw 8th St, Bentonville, AR 72716-0445

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