Organization · Type 2 NPI

Walmart Inc.

Community/Retail Pharmacy · Pagosa Springs, CO

NPI number 1104215540 Active

Practice location

211 Aspen Village Dr
Pagosa Springs, CO 81147-9170

Call (970) 731-9017 Map

Fax (970) 731-9018

Mailing address

702 SW 8th St
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	PDO.1680000089 (CO)

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 …

Another provider at this address

Amanda FisherPharmacist Pagosa Springs, CO NPI 1023987591

Other community/retail pharmacy providers in Pagosa Springs

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NPI record

NPI: 1104215540
Entity type: Organization (Type 2)
Issued: Jan 22, 2015
Last updated: Sep 19, 2025
Status: Active

Other names

<unavail>
Walmart Pharmacy 10-5003 · doing business as
Walmart Pharmacy 10-5003 · doing business as

Authorized official

Sarah Little
Director of Healthcare Contracting
(479) 277-2500

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104215540

Walmart Inc.'s National Provider Identifier is 1104215540, issued on Jan 22, 2015. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Pagosa Springs, CO. The record was last updated on Sep 19, 2025.