Organization · Type 2 NPI

Walmart Inc.

Community/Retail Pharmacy · Rohnert Park, CA

NPI number 1114944451 Active

Practice location

4625 Redwood Dr
Rohnert Park, CA 94928-7941

Call (707) 586-3612 Map

Fax (707) 586-3624

Mailing address

702 SW 8th St
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	PHY37618 (CA)

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 …

7 other providers at this address

Other community/retail pharmacy providers in Rohnert Park

See all in Rohnert Park →

NPI record

NPI: 1114944451
Entity type: Organization (Type 2)
Issued: Jul 16, 2006
Last updated: Jun 17, 2025
Status: Active

Other names

<unavail>
Walmart Pharmacy 10-1755 · doing business as
Walmart Pharmacy 10-1755 · doing business as

Authorized official

Kimberly Canonic
Senior Director, Enrollment
(480) 853-0515

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.

Is this your record? How to update it.

About NPI 1114944451

Walmart Inc.'s National Provider Identifier is 1114944451, issued on Jul 16, 2006. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Rohnert Park, CA. The record was last updated on Jun 17, 2025.