Wal-Mart Stores East LP
NPI 1720506967ActiveOrganization· Pharmacy· Deland, FL
Pharmacy in Deland, Florida, registered in NPPES in September 2017. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment. Medicare paid $22,692 for services to 97 patients in 2024.
Overview
| NPI | 1720506967 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 8, 2017 |
| Last updated in NPPES | Jun 15, 2026 |
| Certified by provider | Jun 15, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | PH31103 | FL |
| 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 (FL) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 97 |
|---|---|
| Services billed | 330 across 9 procedure codes |
| Paid by Medicare | $22,692 |
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