WALMART INC.
NPI 1043238892
Pharmacy - Community/Retail Pharmacy in Riverdale, UT

Q: What is Walmart Inc.'s NPI number?

The NPI number for Walmart Inc. is 1043238892. It was assigned to this organization in the NPPES registry on July 18, 2006.

Q: What is Walmart Inc.'s specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Q: When was this NPI record last updated?

The NPPES record for Walmart Inc. was last updated on June 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 18, 2006CLIA 46D2140289 · Waiver

4848 S 900 W, RIVERDALE, UT 84405(801) 627-0069 Get Directions Write a Review

NPPES record last updated: June 19, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Jun 19, 2025, Feb 28, 2018, Feb 17, 2017 and 1 more (4 updates tracked since 2016).

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About Walmart Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALMART INC. (NPI 1043238892) is a healthcare organization registered as a community/retail pharmacy in Riverdale, Utah and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through November 16, 2027 and lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1043238892

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameWALMART INC.

Location Address4848 S 900 WRiverdale, UT 84405-3726

Mailing Address702 Sw 8th StBentonville, AR 72716-0445

Phone(801) 627-0069

Organization SubpartNo

Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 853-0515

Enumeration DateJuly 18, 2006

Last NPPES UpdateJune 19, 20254 updates tracked since enumeration

NPPES CertifiedJune 19, 2025

✔ NPI 1043238892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in UT · 51608271703

Definition

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 health care providers, collaborative practice, disease state management, and education classes.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

Also ListedPharmacyTaxonomy 333600000X

4848 S 900 W, Riverdale, UT 84405

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Other Identifiers 1

Other2099814Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D2140289

Walmart Pharmacy 10-1708 · Riverdale, UT

Active · expires Nov 16, 2027

CLIA Number46D2140289

Laboratory TypePharmacy

Certificate Effective DateNovember 17, 2025

Certificate Expiration DateNovember 16, 2027

Laboratory DirectorSpencer D. Johnson

Laboratory Phone(801) 627-0069

Laboratory LocationWalmart Pharmacy 10-17084848 S 900 W, Riverdale, UT 84405

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

82 services82 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

72 services72 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

17 services17 patients

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DAVID BOYLE BURNETT O.D.

Optometrist