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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

WAL-MART PUERTO RICO INC
NPI 1285860312
Pharmacy - Community/Retail Pharmacy in Ponce, PR

Active since June 03, 2009
CARRETERA ESTATAL 2, 2188 AVE EDUARDO RUBERTE, PONCE, PR 00716(787) 843-4835(787) 841-4185 Get Directions Write a Review

NPPES record last updated: July 17, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 17, 2026, Jun 5, 2025, Apr 3, 2019 and 3 more (6 updates tracked since 2017).

About Wal-mart Puerto Rico Inc NPPES

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

WAL-MART PUERTO RICO INC (NPI 1285860312), doing business as Sam's Pharmacy 10-6690, is a healthcare organization registered as a community/retail pharmacy in Ponce, Puerto Rico and active in the NPI registry since June 2009. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1285860312
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART PUERTO RICO INC
Location AddressCARRETERA ESTATAL 2, 2188 AVE EDUARDO RUBERTEPonce, PR 00716-0601
Mailing Address1 Customer Dr, Ms 0445Bentonville, AR 72716-0445
Phone(787) 843-4835
Fax(787) 841-4185
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 853-0515
Enumeration DateJune 3, 2009
Last NPPES UpdateJuly 17, 20266 updates tracked since enumeration
NPPES CertifiedJuly 17, 2026
✔ NPI 1285860312 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 PR · 19-F-2746
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

Other Names 1

Doing Business AsSam's Pharmacy 10-6690

Other Identifiers 1

Other2120478Pk

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 ›

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Walmart Pharmacy 10-5802 carries, from the Medicare DMEPOS supplier directory.

Walmart Pharmacy 10-5802

DMEPOS supplier · Canovanas, PROperated by Wal-Mart Puerto Rico, Inc
⋮

Does not accept Medicare assignment

Walmart Pharmacy 10-5802 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)20588009
Medicare Participant SinceJune 25, 2004
Supplier LocationCarretera Pr #3 Km 17.8Canovanas, PR 00729
Phone(787) 957-2715
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.

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 Wal-Mart Puerto Rico Inc's NPI number?

The NPI number for Wal-Mart Puerto Rico Inc is 1285860312. It was assigned to this organization in the NPPES registry on June 3, 2009. The provider is doing business as Sam's Pharmacy 10-6690.

Where is Wal-Mart Puerto Rico Inc located?

Wal-Mart Puerto Rico Inc is located at Carretera Estatal 2 2188 Ave Eduardo Ruberte, Ponce, PR 00716. The listed phone number is (787) 843-4835.

What is Wal-Mart Puerto Rico Inc's specialty?

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

Does Wal-Mart Puerto Rico Inc accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Walmart Pharmacy 10-5802 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 Wal-Mart Puerto Rico 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 41 other insurers list Wal-Mart Puerto Rico 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 Wal-Mart Puerto Rico Inc was last updated on July 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 31 days 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.