Wal-Mart Stores East LP
NPI 1023556511ActiveOrganization· Pharmacy· Yazoo City, MS
Pharmacy in Yazoo City, Mississippi, registered in NPPES in February 2017. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment. Medicare paid $39,380 for services to 169 patients in 2024.
Overview
| NPI | 1023556511 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 6, 2017 |
| Last updated in NPPES | Jun 5, 2025 |
| Certified by provider | Jun 5, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 15069/1.2 | MS |
| 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 (MS) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 169 |
|---|---|
| Services billed | 530 across 11 procedure codes |
| Paid by Medicare | $39,380 |
Other Pharmacy providers in Yazoo City
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