Walmart Stores East LP
NPI 1619424298ActiveOrganization· Pharmacy· Derby, VT
Pharmacy in Derby, Vermont, registered in NPPES in September 2016. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment. Medicare paid $82,955 for services to 326 patients in 2024.
Overview
| NPI | 1619424298 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 1, 2016 |
| Last updated in NPPES | Jun 5, 2025 |
| Certified by provider | Jun 5, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 038.0123545 | VT |
| 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 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (VT) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 326 |
|---|---|
| Services billed | 1,148 across 11 procedure codes |
| Paid by Medicare | $82,955 |