1. Home
  2. Directory
  3. Utah
  4. Provo
  5. Pharmacy
  6. NPI Profile

WALMART INC.
NPI 1447674569
Pharmacy - Community/Retail Pharmacy in Provo, UT

Active since February 10, 2014CLIA 46D2138967 · Waiver
2255 N UNIVERSITY PKWY, PROVO, UT 84604(801) 377-2270(801) 377-2294 Get Directions Write a Review

NPPES record last updated: June 6, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 6, 2025, Jul 19, 2018, Mar 14, 2018 and 3 more (6 updates tracked since 2016).

About Walmart Inc. NPPES

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

WALMART INC. (NPI 1447674569), doing business as Walmart Pharmacy 10-4100, is a healthcare organization registered as a community/retail pharmacy in Provo, Utah and active in the NPI registry since February 2014. The organization holds a CLIA Waiver certificate valid through October 26, 2027 and lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1447674569
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWALMART INC.
Location Address2255 N UNIVERSITY PKWYProvo, UT 84604-1588
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 258-2115 · Fax (479) 277-4331
Phone(801) 377-2270
Fax(801) 377-2294
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 277-6348
Enumeration DateFebruary 10, 2014
Last NPPES UpdateJune 6, 20256 updates tracked since enumeration
NPPES CertifiedJune 6, 2025
✔ NPI 1447674569 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 UT · 8944601
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
2255 N UNIVERSITY PKWY, Provo, UT 84604
Open in Google Maps ↗

Other Names 1

Doing Business AsWalmart Pharmacy 10-4100

Other Identifiers 1

Other2144249Pk

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 46D2138967

Walmart Pharmacy 10-4100 · Provo, UT
Active · expires Oct 26, 2027
CLIA Number46D2138967
Laboratory TypePharmacy
Certificate Effective DateOctober 27, 2025
Certificate Expiration DateOctober 26, 2027
Laboratory DirectorCynthia L. Kerr
Laboratory Phone(385) 219-3077
Laboratory LocationWalmart Pharmacy 10-41002255 N University Parkway, Provo, UT 84604
CLIA data matches this NPI record on: Address Name
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.
58 services58 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.
57 services57 patients

Medical Equipment Supplier Medicare DMEPOS 11

Medicare supplier enrollment and the product categories Wal-Mart Pharmacy 10-4100 carries, from the Medicare DMEPOS supplier directory.

Wal-Mart Pharmacy 10-4100

DMEPOS supplier · Provo, UTOperated by Walmart Inc
⋮

Does not accept Medicare assignment

Wal-Mart Pharmacy 10-4100 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)20444435
Medicare Participant SinceJanuary 1, 2019
Supplier Location2255 N University PkwyProvo, UT 84604
Phone(385) 219-3077
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.

BLAINE F. BIRD, O.D., P.C.
Eyewear Supplier
2255 N UNIVERSITY PKWY, SUITE #1
PROVO, UT 84604
Utah County (801) 374-2220
CYNTHIA LYN KERR BPHARM
Pharmacist
2255 N UNIVERSITY PKWY
PROVO, UT 84604
Utah County (385) 219-3077
DARRELL R BENNETT PHARMD
Pharmacy
2255 N UNIVERSITY PKWY
PROVO, UT 84604
Utah County (385) 219-3077
PROVO OREM FAMILY & COSMETIC DENTISTRY PLLC
Dentist (General Practice)
2255 N UNIVERSITY PKWY, SUITE 39
PROVO, UT 84604
Utah County (706) 207-1102

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 1447674569. It was assigned to this organization in the NPPES registry on February 10, 2014. The provider is doing business as WalMart Pharmacy 10-4100.

Where is Walmart Inc. located?

Walmart Inc. is located at 2255 N University Pkwy, Provo, UT 84604. The listed phone number is (801) 377-2270.

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 10-4100 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 46D2138967) is associated with this NPI, valid through October 26, 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 51 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 6, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.