Organization · Type 2 NPI

Walmart Inc.

Community/Retail Pharmacy · Pomona, CA

NPI number 1205853553 Active

Practice location

80 Rio Rancho Rd
Pomona, CA 91766-4771

Call (909) 620-4077 Map

Fax (909) 620-0747

Mailing address

1 Customer Dr, Ms 0445
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	PHY41296 (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 Pomona

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NPI record

NPI: 1205853553
Entity type: Organization (Type 2)
Issued: Jul 16, 2006
Last updated: Sep 29, 2025
Status: Active

Other names

<unavail>
Walmart Pharmacy 10-2288 · doing business as
Walmart Pharmacy 10-2288 · doing business as

Authorized official

Kimberly Canonic
Sr. Director
(479) 371-1168

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 1205853553

Walmart Inc.'s National Provider Identifier is 1205853553, issued on Jul 16, 2006. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Pomona, CA. The record was last updated on Sep 29, 2025.