Wal-Mart Stores East LP
NPI 1760938013ActiveOrganization· Pharmacy· Valdosta, GA
Pharmacy in Valdosta, Georgia, registered in NPPES in August 2016. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment. Medicare paid $23,906 for services to 98 patients in 2024.
Overview
| NPI | 1760938013 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 28, 2016 |
| Last updated in NPPES | Jun 15, 2026 |
| Certified by provider | Jun 15, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | PHRE010319 | GA |
| 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 (GA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 98 |
|---|---|
| Services billed | 324 across 10 procedure codes |
| Paid by Medicare | $23,906 |
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