# WALMART INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** WalMart Pharmacy 10-4689
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104063635
- **Authorized official:** SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
- **Authorized official phone:** (479) 277-2500

## Contact information

- **Practice address:** 4689 W CEDAR HILLS DR, CEDAR HILLS, UT 84062-8093
- **Practice address phone:** (801) 756-5067
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716
- **Mailing address phone:** (479) 277-1238
- **Mailing address fax:** (479) 277-4331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 7218631-1703 | UT | Yes |

## Other

- **Enumeration date:** 01/21/2009
- **Last updated:** 09/19/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1104063635 | — | UT |
| 01 | — | 2118803 | PK | — |