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WALMART INC
NPI 1710489406
Pharmacy in Warrenton, OR

Active since March 08, 2018CLIA 38D2332574 · Waiver
1791 ENSIGN LANE SE, WARRENTON, OR 97146(503) 861-0644(503) 861-0897 Get Directions Write a Review

NPPES record last updated: June 12, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 12, 2025, Sep 19, 2018, Apr 10, 2018 and 1 more (4 updates tracked since 2018).

About Walmart Inc NPPES

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

WALMART INC (NPI 1710489406) is a healthcare organization registered as a pharmacy in Warrenton, Oregon and active in the NPI registry since March 2018. The organization holds a CLIA Waiver certificate valid through October 20, 2027 and lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1710489406
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWALMART INC
Location Address1791 ENSIGN LANE SEWarrenton, OR 97146-7339
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 277-1242 · Fax (479) 277-4331
Phone(503) 861-0644
Fax(503) 861-0897
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 853-0515
Enumeration DateMarch 8, 2018
Last NPPES UpdateJune 12, 20254 updates tracked since enumeration
NPPES CertifiedJune 12, 2025
✔ NPI 1710489406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in OR · RP-0003387
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
1791 ENSIGN LANE SE, Warrenton, OR 97146
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Other Identifiers 3

Medicaid500745490OR
Medicaid2103875WA
Other2176573Pk

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 38D2332574

Walmart Pharmacy 10-5861 · Warrenton, OR
Active · expires Oct 20, 2027
CLIA Number38D2332574
Laboratory TypePharmacy
Certificate Effective DateOctober 21, 2025
Certificate Expiration DateOctober 20, 2027
Laboratory DirectorMireille K. Rygnestad
Laboratory Phone(503) 861-0146
Laboratory LocationWalmart Pharmacy 10-58611791 SE Ensign Ln, Warrenton, OR 97146
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

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.
245 services243 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.
222 services220 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
23 services23 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
23 services23 patients

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 1710489406. It was assigned to this organization in the NPPES registry on March 8, 2018.

Where is Walmart Inc located?

Walmart Inc is located at 1791 Ensign Lane SE, Warrenton, OR 97146. The listed phone number is (503) 861-0644.

What is Walmart Inc's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Walmart Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2332574) is associated with this NPI, valid through October 20, 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 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 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.