Wal-Mart Stores East LP
NPI 1083631352ActiveOrganization· Pharmacy· California, MD
Pharmacy in California, Maryland, registered in NPPES in July 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment. Medicare paid $56,085 for services to 226 patients in 2024.
Overview
| NPI | 1083631352 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 16, 2006 |
| Last updated in NPPES | Jun 6, 2025 |
| Certified by provider | Jun 6, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | P01775 | MD |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (MD) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 226 |
|---|---|
| Services billed | 751 across 11 procedure codes |
| Paid by Medicare | $56,085 |
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