Wal-Mart Stores East, LP
NPI 1124996491ActiveOrganization· Pharmacy· Jacksonville, FL
Pharmacy in Jacksonville, Florida, registered in NPPES in October 2025. The authorized official on file is Kimberly Canonic, Director Of Health Care Contracting. Enrolled in Medicare as dme supplier - pharmacy.
Overview
| NPI | 1124996491 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 28, 2025 |
| Last updated in NPPES | Jul 21, 2026 |
| Certified by provider | Jul 21, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
| 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 (FL) |
|---|
Other Pharmacy providers in Jacksonville
- 1992154181
- 1831073006
- 1184003311
- 1770883613
- 1255794350
- 1851656607
- 1316733264
- 1467610303
- 1013614742
- 1538563580
- 1649017906
- 1821746090