Wal-Mart Stores East Lp
Wal-Mart Stores East Lp is a healthcare organization registered as Community/Retail Pharmacy in Jackson, MS, holding Type 2 (organization) NPI 1174540595 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1174540595 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores East Lp |
| Other name | <Unavail> |
| Practice address | 2711 GREENWAY DR, Jackson, MS, 39204 |
| Phone | 6019222876 |
| Enumeration date | 2006-07-16 |
| Last updated in NPPES | 2025-06-03 |
Authorized official
| Name | Kimberly Canonic |
|---|---|
| Title | Senior Director, Enrollment |
| Phone | 4802776348 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 333600000X | Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 04056 | MS |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2045611 | Other | — | PK |
| 01400282 | Medicaid | MS | — |
| 1400282 | Medicaid | MS | — |
Copy-ready billing details
Provider: Wal-Mart Stores East Lp NPI: 1174540595 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 2711 GREENWAY DR, Jackson, MS, 39204
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1295813426 | Wal-Mart Stores East, Lp | Organization | Eyewear Supplier | Jackson, MS |
| 1134261282 | Allen Findley | Individual | Optometrist | Jackson, MS |
| 1790998110 | Checkups - Ms LLC | Organization | Nurse Practitioner | Jackson, MS |
| 1134419559 | Findley Vision, Inc | Organization | Optometrist | Jackson, MS |
| 1235553322 | Mississippi Vision Center | Organization | Optometrist | Jackson, MS |
| 1326438706 | Channing Wells | Individual | Optometrist | Jackson, MS |
| 1366042459 | Jason Frith | Individual | Pharmacist | Jackson, MS |
| 1851992408 | Nicholas Barham | Individual | Pharmacist | Jackson, MS |
Verify this record
Cross-check NPI 1174540595 against the authoritative CMS record: view Wal-Mart Stores East Lp on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Wal-Mart Stores East Lp?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-06-03.