Wal-Mart Stores East LP
NPI 1861859456ActiveOrganization· Pharmacy· Port St Lucie, FL
Pharmacy in Port St Lucie, Florida, registered in NPPES in January 2016. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment. Medicare paid $33,326 for services to 130 patients in 2024.
Overview
| NPI | 1861859456 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 27, 2016 |
| Last updated in NPPES | Jun 9, 2025 |
| Certified by provider | Jun 9, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | PH29886 | 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 | 130 |
|---|---|
| Services billed | 444 across 10 procedure codes |
| Paid by Medicare | $33,326 |
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