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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.

WALMART INC.
NPI 1467861112
Pharmacy - Community/Retail Pharmacy in San Jose, CA

Active since August 07, 2014CLIA 05D2341380 · Waiver
1450 MONTEREY RD, SAN JOSE, CA 95110(408) 454-4509(408) 454-4510 Get Directions Write a Review

NPPES record last updated: June 15, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 6, 2025, May 8, 2018, Feb 27, 2018 and 4 more (7 updates tracked since 2015).

About Walmart Inc. NPPES

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

WALMART INC. (NPI 1467861112), doing business as Walmart Pharmacy 10-4174, is a healthcare organization registered as a community/retail pharmacy in San Jose, California and active in the NPI registry since August 2014. The organization holds a CLIA Waiver certificate valid through March 31, 2028 and lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1467861112
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWALMART INC.
Location Address1450 MONTEREY RDSan Jose, CA 95110-3445
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 258-2115 · Fax (479) 277-4331
Phone(408) 454-4509
Fax(408) 454-4510
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 277-6348
Enumeration DateAugust 7, 2014
Last NPPES UpdateJune 15, 20267 updates tracked since enumeration
NPPES CertifiedJune 15, 2026
✔ NPI 1467861112 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 · PHY52160
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
1450 MONTEREY RD, San Jose, CA 95110
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Other Names 1

Doing Business AsWalmart Pharmacy 10-4174

Other Identifiers 2

Other2148147Pk
Medicaid1467861112CA

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 05D2341380

Walmart Pharmacy #10-4174 · San Jose, CA
Active · expires Mar 31, 2028
CLIA Number05D2341380
Laboratory TypePharmacy
Certificate Effective DateApril 1, 2026
Certificate Expiration DateMarch 31, 2028
Laboratory DirectorTai Nguyen
Laboratory Phone(408) 454-4508
Laboratory LocationWalmart Pharmacy #10-41741450 Monterey Rd, San Jose, CA 95110
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.
68 services66 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.
62 services60 patients

Medical Equipment Supplier Medicare DMEPOS 11

Medicare supplier enrollment and the product categories Walmart Pharmacy 10-4174 carries, from the Medicare DMEPOS supplier directory.

Walmart Pharmacy 10-4174

DMEPOS supplier · San Jose, CAOperated by Walmart Inc
⋮

Does not accept Medicare assignment

Walmart Pharmacy 10-4174 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)20442887
Medicare Participant SinceJanuary 1, 2019
Supplier Location1450 Monterey HwySan Jose, CA 95110
Phone(408) 454-4509
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.

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 1467861112. It was assigned to this organization in the NPPES registry on August 7, 2014. The provider is doing business as WalMart Pharmacy 10-4174.

Where is Walmart Inc. located?

Walmart Inc. is located at 1450 Monterey Rd, San Jose, CA 95110. The listed phone number is (408) 454-4509.

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 10-4174 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 05D2341380) is associated with this NPI, valid through March 31, 2028. 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 49 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 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 56 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.