WALMART INC. (NPI# 1205273984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205273984 |
| Entity Type | Organization |
| Organization Name | WALMART INC. |
| Other Organization Name | WALMART PHARMACY 10-5976 |
| Practice Address |
11505 Ulysses St Ne Blaine MN 55434-4239 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 7633545402 |
| Practice Fax Number | 7633545396 |
| Mailing Telephone | 4792048741 |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING) |
| Authorized Official Telephone | 4792772500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
264163 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2140640 | 01 | |
| MN | 1205273984 | 05 |
| Other Name | Type Code |
|---|---|
| WalMart Pharmacy 10-5976 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336661461 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 8270 Delta Shores Cir S, Sacramento, CA 95832-9101 | 2017-07-11 |
| 1710407895 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 6973 Blue Diamond Rd, Las Vegas, NV 89178-9213 | 2017-06-21 |
| 1295265072 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 44100 Jefferson St Ste F, Indio, CA 92201-2715 | 2017-06-14 |
| 1528594983 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 898 S 2550 E, Spanish Fork, UT 84660 | 2017-05-04 |
| 1922533082 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 9600 N Metro Pkwy W, Phoenix, AZ 85051-1402 | 2017-04-26 |
| 1730612425 | Walmart Inc. | Pharmacy | 9400 Ralston Rd, Arvada, CO 80002-2004 | 2017-04-10 |
| 1730628728 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 5210 S Highway 95, Fort Mohave, AZ 86426-9223 | 2017-02-23 |
| 1881132926 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 875 E H St, Chula Vista, CA 91910-7807 | 2017-02-09 |
| 1104364157 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 831 E Fort Lowell Rd, Tucson, AZ 85719-2109 | 2017-02-09 |
| 1588109797 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 5320 10th Ave S, Great Falls, MT 59405-5633 | 2016-12-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | WALMART INC | 708 Sw 8th Street, Bentonville, AR 72716 |
| Colorado Business Entities | Walmart Inc. | 708 Sw 8th Street, Bentonville, AR 72716 |
| Oregon Corporations, Companies and Business Names | WALMART INC. | 708 Sw 8th Street, Bentonville, AR 72716 |
| Iowa Business Entities | WALMART INC. | 708 Sw 8th Street, Bentonville, AR 72716 |
| New York State Corporations | WALMART INC. | 28 Liberty Street, New York, New York 10005 |
| Street Address |
11505 ULYSSES ST NE |
| City | BLAINE |
| State | MN |
| Zip Code | 55434-4239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134727803 | Krystal Sievert | Pharmacist | 11505 Ulysses St Ne, Blaine, MN 55434-4239 | 2020-10-14 |
| 1215535273 | Kyle Loftus | Pharmacist | 11505 Ulysses St Ne, Blaine, MN 55434-4239 | 2020-10-13 |
| 1417555335 | Joshua Dehn | Pharmacist | 11505 Ulysses St Ne, Blaine, MN 55434-4239 | 2020-10-13 |
| 1639502842 | Wal-mart Stores, Inc. | Technician/Technologist | 11505 Ulysses St Ne, Blaine, MN 55434-4239 | 2013-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023628591 | Rahul Farmah | Optometrist | 680 Hwy 10 Ne, Blaine, MN 55434 | 2020-08-08 |
| 1033770714 | Enduring Home Health Care Corp | Home Health | 10812 Fillmore Street, Blaine, MN 55434 | 2019-06-24 |
| 1932762408 | Vital Agency LLC | In Home Supportive Care | 12864 Fillmore Street Ne, Blaine, MN 55434 | 2019-04-19 |
| 1548751654 | Dustin Adam Kakach | Pharmacist | 600 County Hwy 10, Blaine, MN 55434 | 2018-05-24 |
| 1598253445 | Jacob James Apland | Behavioral Analyst | 12401 Oak Park Blvd Ne Apt 316, Blaine, MN 55434 | 2018-04-26 |
| 1962921924 | Mw Minnetonka Operating LLC | Assisted Living Facility | 1005 Paul Parkway Ne, Blaine, MN 55434 | 2017-09-11 |
| 1922526961 | Blaine Asc, LLC | Clinic/Center | 11225 Ulysses Street Northeast, Blaine, MN 55434 | 2017-08-30 |
| 1629591334 | Minnehaha Transportation Inc | Non-emergency Medical Transport (VAN) | 2507 Walnut St, Roseville, MN 55434 | 2017-07-25 |
| 1629590872 | Alexandra Staum Reif | Pediatrics | 11107 Ulysses Street Ne, Suite 100, Blaine, MN 55434 | 2017-07-10 |
| 1962939546 | Nicolette Gengel | Dentist | 1384 109th Ave Ne Ste 200, Blaine, MN 55434 | 2017-05-15 |
| Find all providers in zip 55434 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932115573 | Walgreen Co | Pharmacy | 12480 Aberdeen St Ne, Blaine, MN 55449-4721 | 2006-08-01 |
| 1245339548 | Grand St Paul Cvs LLC | Pharmacy | 2357 108th Ln Ne, Blaine, MN 55449-5222 | 2006-09-22 |
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| 1497368633 | Sawtooth Mountain Clinic, Inc. | Pharmacy | 513 5th Ave W Rm 201, Grand Marais, MN 55604-3017 | 2020-08-27 |
| 1891313326 | Rochester Community Pharmacy LLC | Pharmacy | 1604 1st St Nw, Rochester, MN 55901-0318 | 2020-07-10 |
| 1134745730 | Elko New Market Family Pharmacy, LLC | Pharmacy | 117 Old Town Road, Elko New Market, MN 55054 | 2020-06-19 |
| 1578187456 | Coborns Inc | Pharmacy | 15700 88th St Ne, Otsego, MN 55330 | 2020-06-05 |
| 1205460169 | Genoa Healthcare, LLC | Pharmacy | 1515 Energy Park Dr Ste 110, Saint Paul, MN 55108-5229 | 2020-02-28 |
| 1801438361 | The Duluth Clinic, Ltd. | Pharmacy | 2 Division St Ste A, Deer River, MN 56636-8779 | 2019-10-16 |
| 1265084792 | Nudak Ventures, LLC | Pharmacy | 5418 Saint Croix Trl, North Branch, MN 55056-4203 | 2019-07-15 |
| 1659938116 | Sterlingrx Inc | Pharmacy | 1312 Northland Dr Ste 500, Mendota Heights, MN 55120-1436 | 2019-05-21 |
| 1639734346 | Seward Pharmacy LLC | Pharmacy | 2209 E Lake St, Minneapolis, MN 55407-4563 | 2019-05-08 |
| 1093370694 | Minnesota Ave N Pharmacy Services Limited | Pharmacy | 226 Minnesota Ave N, Aitkin, MN 56431-1412 | 2019-05-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.