Wal-Mart Stores Texas LLC
NPI 1720436959ActiveOrganization· Pharmacy· Lubbock, TX
Pharmacy in Lubbock, Texas, registered in NPPES in May 2016. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment. Medicare paid $22,610 for services to 103 patients in 2024.
Overview
| NPI | 1720436959 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 27, 2016 |
| Last updated in NPPES | Jun 16, 2025 |
| Certified by provider | Jun 16, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 30805 | TX |
| 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 (TX) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 103 |
|---|---|
| Services billed | 334 across 8 procedure codes |
| Paid by Medicare | $22,610 |
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