Walmart Inc.
NPI 1649635459ActiveOrganization· Pharmacy· Fayetteville, AR
Pharmacy in Fayetteville, Arkansas, registered in NPPES in December 2015. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment. Medicare paid $30,806 for services to 118 patients in 2024.
Overview
| NPI | 1649635459 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 21, 2015 |
| Last updated in NPPES | Jun 10, 2025 |
| Certified by provider | Jun 10, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | AR20838 | AR |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (AR) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 118 |
|---|---|
| Services billed | 422 across 8 procedure codes |
| Paid by Medicare | $30,806 |
Other Pharmacy providers in Fayetteville
- 1407878283
- 1912306036
- 1508966821
- 1093861825
- 1215943964
- 1376558635
- 1760803035
- 1881609147
- 1902052285
- 1952564205
- 1689594046