Wal-Mart Stores East , LP
NPI 1396117735ActiveOrganization· Pharmacy· Shreveport, LA
Pharmacy in Shreveport, Louisiana, registered in NPPES in October 2015. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment. Medicare paid $42,062 for services to 199 patients in 2024.
Overview
| NPI | 1396117735 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 26, 2015 |
| Last updated in NPPES | Jun 10, 2025 |
| Certified by provider | Jun 10, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | PHY.007230-RC | LA |
| 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 (LA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 199 |
|---|---|
| Services billed | 580 across 11 procedure codes |
| Paid by Medicare | $42,062 |
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