Wal-Mart Stores East LP
NPI 1568833192ActiveOrganization· Pharmacy· Dothan, AL
Pharmacy in Dothan, Alabama, registered in NPPES in October 2015. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment. Medicare paid $21,254 for services to 110 patients in 2024.
Overview
| NPI | 1568833192 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 8, 2015 |
| Last updated in NPPES | Jun 11, 2025 |
| Certified by provider | Jun 11, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 114597 | AL |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| 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 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (AL) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 110 |
|---|---|
| Services billed | 308 across 10 procedure codes |
| Paid by Medicare | $21,254 |
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