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

Walmart Inc

Organization Durable Medical Equipment & Medical Supplies · NPI 1831117308

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

Licensed in
CA
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

15960 Dam Rd
Clearlake, CA 95422-7906
Phone: (707) 994-1671
Fax: (707) 994-1673
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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 PHY39666 (CA)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1831117308
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Canonic — Senior Director, Enrollment · (480) 277-6348
Other names Walmart Pharmacy 10-1979
NPI enumeratedJuly 17, 2006
Last updated in NPPESJune 9, 2025
Certification dateJune 9, 2025
Mailing address702 Sw 8th St, Bentonville, AR 72716-0445

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