Wal-Mart Stores Texas LLC
NPI 1205387628ActiveOrganization· Pharmacy· El Paso, TX
Pharmacy in El Paso, Texas, registered in NPPES in October 2016. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment. Medicare paid $26,663 for services to 106 patients in 2024.
Overview
| NPI | 1205387628 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 20, 2016 |
| Last updated in NPPES | Jun 10, 2025 |
| Certified by provider | Jun 10, 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 · 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 (TX) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 106 |
|---|---|
| Services billed | 358 across 12 procedure codes |
| Paid by Medicare | $26,663 |
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