Wal-Mart Stores East LP
NPI 1417405739ActiveOrganization· Pharmacy· Oklahoma City, OK
Pharmacy in Oklahoma City, Oklahoma, registered in NPPES in September 2016. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment. Medicare paid $40,277 for services to 190 patients in 2024.
Overview
| NPI | 1417405739 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 15, 2016 |
| Last updated in NPPES | Jun 9, 2025 |
| Certified by provider | Jun 9, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 77700 | OK |
| 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 (OK) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 190 |
|---|---|
| Services billed | 592 across 10 procedure codes |
| Paid by Medicare | $40,277 |
Other pharmacies in Oklahoma City
- 1063316016
- 1063427037
- 1063968634
- 1073520953
- 1073528048
- 1073981486
- 1124035019
- 1154336139
- 1154504389
- 1164437133
- 1184367492
- 1215959937
All 61 pharmacies in Oklahoma City · All pharmacies in Oklahoma