WALMART INC.
NPI 1578945952
Pharmacy - Community/Retail Pharmacy in Vancouver, WA

Active since June 23, 2015CLIA 50D2177770 · Waiver
14505 NE FOURTH PLAIN BLVD, VANCOUVER, WA 98682(360) 258-2653(360) 258-2652 Get Directions Write a Review

NPPES record last updated: June 18, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 18, 2025, Jul 19, 2018, Feb 26, 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 1578945952), doing business as Walmart Pharmacy 10-5461, is a healthcare organization registered as a community/retail pharmacy in Vancouver, Washington and active in the NPI registry since June 2015. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1578945952
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWALMART INC.
Location Address14505 NE FOURTH PLAIN BLVDVancouver, WA 98682-5003
Mailing Address702 Sw 8th StBentonville, AR 72716-0445
Fax(360) 258-2652
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 853-0515
Enumeration DateJune 23, 2015
Last NPPES UpdateJune 18, 20256 updates tracked since enumeration
NPPES CertifiedJune 18, 2025
NPI 1578945952 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 WA · PHAR.CF.60581870
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
14505 NE FOURTH PLAIN BLVD, Vancouver, WA 98682

Other Names 1

Doing Business AsWalmart Pharmacy 10-5461

Other Identifiers 1

Other2152781Pk

Accepted 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 50D2177770

Walmart Pharmacy 10-5461 · Vancouver, WA
Active · expires Apr 4, 2028
CLIA Number50D2177770
Laboratory TypePharmacy
Certificate Effective DateJanuary 17, 2020
Certificate Expiration DateApril 4, 2028
Laboratory DirectorTadesse Melesse
Laboratory Phone(360) 258-2653
Laboratory LocationWalmart Pharmacy 10-546114505 NE Fourth Plain Blvd, Vancouver, WA 98682
CLIA data matches this NPI record on: Address Name Phone
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.
92 services92 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.
86 services86 patients

Other Providers at the Same Location NPPES 6

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

Optometrist
14505 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98682
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
14505 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98682
Optometrist
14505 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98682
Pharmacist
14505 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98682
Technician/Technologist (Optician)
14505 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98682
Eyewear Supplier
14505 NE FOURTH PLAIN BLVD
VANCOUVER, WA 98682

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 1578945952. It was assigned to this organization in the NPPES registry on June 23, 2015. The provider is doing business as Walmart Pharmacy 10-5461.

Where is Walmart Inc. located?

Walmart Inc. is located at 14505 NE Fourth Plain Blvd, Vancouver, WA 98682. The listed phone number is (360) 258-2653.

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. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2177770) is associated with this NPI, valid through April 4, 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 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.