WALMART INC.
NPI 1235171075
Pharmacy - Community/Retail Pharmacy in Country Club Hills, IL

Active since June 12, 2006CLIA 14D2126853 · Waiver
4005 167TH ST, COUNTRY CLUB HILLS, IL 60478(708) 647-6738 Get Directions Write a Review

NPPES record last updated: June 16, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 16, 2025, Sep 1, 2023, Feb 28, 2018 and 1 more (4 updates tracked since 2017).

About Walmart Inc. NPPES

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

WALMART INC. (NPI 1235171075) is a healthcare organization registered as a community/retail pharmacy in Country Club Hills, Illinois and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through March 5, 2027 and lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1235171075
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWALMART INC.
Location Address4005 167TH STCountry Club Hills, IL 60478-2070
Mailing Address702 Sw 8th StBentonville, AR 72716-0445
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 853-0515
Enumeration DateJune 12, 2006
Last NPPES UpdateJune 16, 20254 updates tracked since enumeration
NPPES CertifiedJune 16, 2025
NPI 1235171075 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License Licensed in IL · 054015827
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
4005 167TH ST, Country Club Hills, IL 60478

Other Identifiers 1

Other2023178Pk

Accepted 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 14D2126853

Walmart Pharmacy 10-5486 · Country Club Hills, IL
Active · expires Mar 5, 2027
CLIA Number14D2126853
Laboratory TypePharmacy
Certificate Effective DateMarch 6, 2025
Certificate Expiration DateMarch 5, 2027
Laboratory DirectorEmmanuel Yemoh
Laboratory Phone(708) 647-6738
Laboratory LocationWalmart Pharmacy 10-54864005 167th St, Country Club Hills, IL 60478
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 2

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.
54 services54 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.
49 services49 patients

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories Wal Mart Pharmacy 10-5486 carries, from the Medicare DMEPOS supplier directory.

Wal Mart Pharmacy 10-5486

DMEPOS supplier · Country Club Hills, ILOperated by Walmart Inc

Does not accept Medicare assignment

Wal Mart Pharmacy 10-5486 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20443685
Medicare Participant SinceJanuary 1, 2019
Supplier Location4005 167th StCountry Club Hills, IL 60478
Supplier Specialties
Pharmacy Optician

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

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.

Optometrist
4005 167TH ST
COUNTRY CLUB HILLS, IL 60478
Pharmacist
4005 167TH ST
COUNTRY CLUB HILLS, IL 60478
Pharmacist
4005 167TH ST
COUNTRY CLUB HILLS, IL 60478
Pharmacist
4005 167TH ST
COUNTRY CLUB HILLS, IL 60478
Eyewear Supplier
4005 167TH ST
COUNTRY CLUB HILLS, IL 60478

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Walmart Inc.'s NPI number?

The NPI number for Walmart Inc. is 1235171075. It was assigned to this organization in the NPPES registry on June 12, 2006.

Where is Walmart Inc. located?

Walmart Inc. is located at 4005 167th St, Country Club Hills, IL 60478. The listed phone number is (708) 647-6738.

What is Walmart Inc.'s specialty?

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

Does Walmart Inc. accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Wal Mart Pharmacy 10-5486 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Walmart Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2126853) is associated with this NPI, valid through March 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Walmart Inc. accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 50 other insurers list Walmart Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Walmart Inc. was last updated on June 16, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.