Walmart Inc
NPI 1255865853ActiveOrganization· Pharmacy· Collinsville, IL
Pharmacy in Collinsville, Illinois, registered in NPPES in April 2017. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment. Medicare paid $52,095 for services to 220 patients in 2024.
Overview
| NPI | 1255865853 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 20, 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 · 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 (IL) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 220 |
|---|---|
| Services billed | 732 across 11 procedure codes |
| Paid by Medicare | $52,095 |
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