Organization · Type 2 NPI

Walmart Inc.

Community/Retail Pharmacy · Lake Elsinore, CA

NPI number 1972520385 Active

Practice location

29260 Central Ave
Lake Elsinore, CA 92532-2232

Call (951) 245-4329 Map

Fax (951) 245-2851

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	PHY40343 (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 …

Another provider at this address

Joe Anigbogu, PharmD, RPHPharmacist Lake Elsinore, CA NPI 1053094508

Other community/retail pharmacy providers in Lake Elsinore

See all in Lake Elsinore →

NPI record

NPI: 1972520385
Entity type: Organization (Type 2)
Issued: Jul 16, 2006
Last updated: Jun 5, 2025
Status: Active

Other names

<unavail>
Walmart Pharmacy 10-2077 · doing business as
Walmart Pharmacy 10-2077 · doing business as

Authorized official

Kimberly Canonic
Senior Director, Enrollment
(480) 277-6348

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 1972520385

Walmart Inc.'s National Provider Identifier is 1972520385, issued on Jul 16, 2006. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Lake Elsinore, CA. The record was last updated on Jun 5, 2025.