Wal-Mart Stores East, Lp

Wal-Mart Stores East, Lp is a healthcare organization registered as Community/Retail Pharmacy in Pace, FL, holding Type 2 (organization) NPI 1194613869 since 2025. The authorized official on file is Kimberly Canonic, Director of Health Care Contracting.

✓ Active NPI ✓ Valid NPI checksum

NPI	1194613869
Entity type	Organization (Type 2)
Legal business name	Wal-Mart Stores East, Lp
Practice address	4239 BERRYHILL ROAD, Pace, FL, 32571
Phone	8504639461
Fax	8504639464
Enumeration date	2025-06-24
Last updated in NPPES	2025-12-09

Authorized official

Name	Kimberly Canonic
Title	Director of Health Care Contracting
Phone	4802776348

Taxonomy & classification

Taxonomy code	Specialty	Primary	License	State
332B00000X	Durable Medical Equipment & Medical Supplies	Secondary	—	—
3336C0003X	Community/Retail Pharmacy	Primary	—	—

Other identifiers

Identifier	Type	State	Issuer
128278400	Medicaid	FL	—
128278700	Medicaid	FL	—

Copy-ready billing details

Provider: Wal-Mart Stores East, Lp
NPI: 1194613869
Taxonomy: 3336C0003X (Community/Retail Pharmacy)
Address: 4239 BERRYHILL ROAD, Pace, FL, 32571

Verify this record

Cross-check NPI 1194613869 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

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2025-12-09. Verify at npiregistry.cms.hhs.gov.

Where is Wal-Mart Stores East, Lp located?

The practice location on file with NPPES is in Pace, FL.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-12-09.