Wal-Mart Stores East LP
NPI 1629526694ActiveOrganization· Pharmacy· Ocean Springs, MS
Pharmacy in Ocean Springs, Mississippi, registered in NPPES in September 2016. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment. Medicare paid $29,643 for services to 126 patients in 2024.
Overview
| NPI | 1629526694 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 19, 2016 |
| Last updated in NPPES | Jun 10, 2025 |
| Certified by provider | Jun 10, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 14836/1.2 | MS |
| 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 (MS) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 126 |
|---|---|
| Services billed | 404 across 10 procedure codes |
| Paid by Medicare | $29,643 |
Other Pharmacy providers in Ocean Springs
- 1770660201
- 1124128566
- 1144743238