1. Home
  2. Directory
  3. NPI Profile

WAL-MART PUERTO RICO INC
NPI 1396768461
Pharmacy - Community/Retail Pharmacy in Hatillo, PR

Active since July 26, 2006
CARR 2 KM 84.2, HATILLO, PR 00659(787) 544-7265(787) 820-5322 Get Directions Write a Review

NPPES record last updated: July 17, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 17, 2026, Jun 17, 2025, Apr 3, 2019 and 3 more (6 updates tracked since 2015).

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 1396768461), doing business as Sam's Pharmacy 10-6270, is a healthcare organization registered as a community/retail pharmacy in Hatillo, Puerto Rico and active in the NPI registry since July 2006. The organization lists Kimberly Canonic, Sr Director, as its authorized official.

NPPES Registry Identity

NPI1396768461
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART PUERTO RICO INC
Location AddressCARR 2 KM 84.2Hatillo, PR 00659-0000
Mailing Address1 Customer Dr, Ms 0445Bentonville, AR 72716-0445
Phone(787) 544-7265
Fax(787) 820-5322
Organization SubpartNo
Authorized OfficialKimberly CanonicSr Director · (480) 853-0515
Enumeration DateJuly 26, 2006
Last NPPES UpdateJuly 17, 20266 updates tracked since enumeration
NPPES CertifiedJuly 17, 2026
✔ NPI 1396768461 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 PR · 19-F-2215
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

Other Names 1

Doing Business AsSam's Pharmacy 10-6270

Other Identifiers 1

Other2087309Pk

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 Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wal-mart Puerto Rico Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StatePuerto RicoEnrollment IDO20100930009999DME · PharmacyDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

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 1396768461. It was assigned to this organization in the NPPES registry on July 26, 2006. The provider is doing business as Sam's Pharmacy 10-6270.

Where is Wal-Mart Puerto Rico Inc located?

Wal-Mart Puerto Rico Inc is located at Carr 2 Km 84.2, Hatillo, PR 00659. The listed phone number is (787) 544-7265.

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.

Is Wal-Mart Puerto Rico Inc enrolled in Medicare?

Yes. Wal-Mart Puerto Rico Inc is registered in the Medicare PECOS enrollment system.

When is Wal-Mart Puerto Rico Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Puerto Rico, Pharmacy) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

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 Arkansas Health & Wellness and 46 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 3 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.