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WALMART INC.
NPI 1245676667
Pharmacy - Community/Retail Pharmacy in San Diego, CA

Active since May 13, 2013
2121 IMPERIAL AVE, SAN DIEGO, CA 92102(619) 849-5834(619) 849-5835 Get Directions Write a Review

NPPES record last updated: June 5, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 5, 2025, Jul 19, 2018, May 23, 2018 and 3 more (6 updates tracked since 2017).

About Walmart Inc. NPPES

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

WALMART INC. (NPI 1245676667), doing business as Walmart Pharmacy 10-5638, is a healthcare organization registered as a community/retail pharmacy in San Diego, California and active in the NPI registry since May 2013. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1245676667
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWALMART INC.
Location Address2121 IMPERIAL AVESan Diego, CA 92102-3826
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 204-8741 · Fax (479) 277-4331
Phone(619) 849-5834
Fax(619) 849-5835
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 277-6348
Enumeration DateMay 13, 2013
Last NPPES UpdateJune 5, 20256 updates tracked since enumeration
NPPES CertifiedJune 5, 2025
✔ NPI 1245676667 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 CA · PHY51223
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
2121 IMPERIAL AVE, San Diego, CA 92102
Open in Google Maps ↗

Other Names 1

Doing Business AsWalmart Pharmacy 10-5638

Other Identifiers 1

Other2140366Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Moda Health Plan, Inc..Insurance ›

Medical Equipment Supplier Medicare DMEPOS 11

Medicare supplier enrollment and the product categories Walmart Pharmacy 10-5638 carries, from the Medicare DMEPOS supplier directory.

Walmart Pharmacy 10-5638

DMEPOS supplier · San Diego, CAOperated by Walmart Inc
⋮

Does not accept Medicare assignment

Walmart Pharmacy 10-5638 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)20440559
Medicare Participant SinceJanuary 1, 2019
Supplier Location2121 Imperial AveSan Diego, CA 92102
Phone(619) 849-5834
Supplier Specialties
Pharmacy

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 4

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

FAMILY HEALTH CENTERS OF SAN DIEGO, INC
Clinic/Center (Federally Qualified Health Center (FQHC))
2121 IMPERIAL AVE
SAN DIEGO, CA 92102
San Diego County (619) 515-2333
YOUNG WOO CHUNG
Pharmacist
2121 IMPERIAL AVE
SAN DIEGO, CA 92102
San Diego County (619) 849-5834
SAMIRA AMINI
Pharmacist
2121 IMPERIAL AVE
SAN DIEGO, CA 92102
San Diego County (858) 717-2012
LISA P NGUYEN
Pharmacist
2121 IMPERIAL AVE
SAN DIEGO, CA 92102
San Diego County (619) 849-5729

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 1245676667. It was assigned to this organization in the NPPES registry on May 13, 2013. The provider is doing business as WalMart Pharmacy 10-5638.

Where is Walmart Inc. located?

Walmart Inc. is located at 2121 Imperial Ave, San Diego, CA 92102. The listed phone number is (619) 849-5834.

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, Walmart Pharmacy 10-5638 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.

What insurance does Walmart Inc. accept?

Health plans from Medica and Moda Health Plan, Inc. 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 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.