Organization · Type 2 NPI

Walmart Inc.

Community/Retail Pharmacy · Roseville, CA

NPI number 1912307935 Active

Practice location

1400 Lead Hill Blvd
Roseville, CA 95661-2949

Call (916) 783-9022 Map

Fax (916) 724-0022

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	52008 (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 Roseville

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NPI record

NPI: 1912307935
Entity type: Organization (Type 2)
Issued: Aug 27, 2014
Last updated: Jul 8, 2025
Status: Active

Other names

<unavail>
Walmart Pharmacy 10-4202 · doing business as
Walmart Pharmacy 10-4202 · 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 1912307935

Walmart Inc.'s National Provider Identifier is 1912307935, issued on Aug 27, 2014. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Roseville, CA. The record was last updated on Jul 8, 2025.