Wal-Mart Stores Texas LLC
NPI 1003347261ActiveOrganization· Pharmacy· Grand Prairie, TX
Pharmacy in Grand Prairie, Texas, registered in NPPES in March 2017. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment. Medicare paid $10,603 for services to 43 patients in 2024.
Overview
| NPI | 1003347261 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 21, 2017 |
| Last updated in NPPES | Jun 12, 2025 |
| Certified by provider | Jun 12, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
| 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 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (TX) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 43 |
|---|---|
| Services billed | 136 across 8 procedure codes |
| Paid by Medicare | $10,603 |
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