Organization · Type 2 NPI

Walmart Inc.

Community/Retail Pharmacy · Modesto, CA

NPI number 1225287352 Active

Practice location

3848 Mchenry Ave
Modesto, CA 95356-1586

Call (209) 342-0960 Map

Fax (209) 342-0962

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
Community/Retail Pharmacy Primary	3336C0003X	PHY49198 (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 …

9 other providers at this address

Other community/retail pharmacy providers in Modesto

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NPI record

NPI: 1225287352
Entity type: Organization (Type 2)
Issued: Sep 12, 2008
Last updated: Sep 29, 2025
Status: Active

Other names

<unavail>
Walmart Pharmacy 10-5710 · doing business as
Walmart Pharmacy 10-5710 · doing business as

Authorized official

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

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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 1225287352

Walmart Inc.'s National Provider Identifier is 1225287352, issued on Sep 12, 2008. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Modesto, CA. The record was last updated on Sep 29, 2025.