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Contact Information

WALMART INC.
2607 W MAIN ST
SHELBYVILLE, IL62565
 Phone: 217-774-1571
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for WALMART INC.

NPI # 1710042833
LBN Legal business name WALMART INC.
Authorized official KIMBERLY CANONIC - (SENIOR DIRECTOR, ENROLLMENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/27/2006
Last updated 07/09/2025 - About 11 months ago
Identifiers
IL License # 054016093
Other 2023282 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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