Wal-Mart Stores East LP
NPI 1992168470ActiveOrganization· Pharmacy· Jacksonville, FL
Pharmacy in Jacksonville, Florida, registered in NPPES in April 2016. The authorized official on file is Kimberly Canonic, Director, Enrollment Services. Medicare paid $16,059 for services to 76 patients in 2024.
Overview
| NPI | 1992168470 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 1, 2016 |
| Last updated in NPPES | Jun 10, 2025 |
| Certified by provider | Jun 10, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | PH29981 | FL |
| 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) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 76 |
|---|---|
| Services billed | 236 across 12 procedure codes |
| Paid by Medicare | $16,059 |
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