Walmart Inc.

Community/Retail Pharmacy · Decorah, IA

Organization Active NPI

NPI number 1669499042

Practice location

1798 Old Stage Rd
Decorah, IA 52101-7497
Phone
(563) 382-8456
Fax
(563) 382-8654

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NPI record

NPI
1669499042
Entity type
Organization (Type 2)
Enumeration date
July 16, 2006
Last updated
June 4, 2025
Certified
June 4, 2025
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Community/Retail Pharmacy Primary 3336C0003X 862 IA
Durable Medical Equipment & Medical Supplies 332B00000X — —
Pharmacy 333600000X — —

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0445
Phone
(479) 277-2500
Fax
(479) 277-4331

Authorized official

Name
Kimberly Canonic
Title
Senior Director, Enrollment
Phone
(480) 277-6348

Other names

  • Walmart Pharmacy 10-0913

About Walmart Inc.

Walmart Inc. is a healthcare organization registered in the NPI registry with the primary taxonomy Community/Retail Pharmacy (code 3336C0003X). The practice location is 1798 Old Stage Rd, Decorah, IA 52101-7497. The NPI number 1669499042 was assigned on July 16, 2006 and the record was last updated on June 4, 2025.

Walmart Inc. lists a license in the registry: #862 (IA) for Community/Retail Pharmacy. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Kimberly Canonic, Senior Director, Enrollment.

Frequently asked questions

What is the NPI number of Walmart Inc.?

The NPI number is 1669499042.

What is the phone number of Walmart Inc.?

The phone number listed for the practice location is (563) 382-8456.

Where is Walmart Inc. located?

1798 Old Stage Rd, Decorah, IA 52101-7497.

What is the taxonomy code for Walmart Inc.?

The primary taxonomy code is 3336C0003X – Community/Retail Pharmacy; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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