Wal-Mart Stores East Lp
Wal-Mart Stores East Lp is a healthcare organization registered as Community/Retail Pharmacy in Covington, LA, holding Type 2 (organization) NPI 1245257583 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1245257583 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores East Lp |
| Other name | <Unavail> |
| Practice address | 880 N HIGHWAY 190, Covington, LA, 70433 |
| Phone | 9858939918 |
| Enumeration date | 2006-07-16 |
| Last updated in NPPES | 2025-06-02 |
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 | 4778RC | LA |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1270440 | Medicaid | LA | — |
| 2032141 | Other | — | PK |
Copy-ready billing details
Provider: Wal-Mart Stores East Lp NPI: 1245257583 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 880 N HIGHWAY 190, Covington, LA, 70433
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1326015751 | Earl Primo | Individual | Optometrist | Covington, LA |
| 1710916978 | Melanie Nuss | Individual | Family Nurse Practitioner | Covington, LA |
| 1871690883 | Mark Siverd | Individual | Optometrist | Covington, LA |
| 1902989924 | Wal-Mart Stores Louisiana, LLC | Organization | Eyewear Supplier | Covington, LA |
| 1558502971 | Earl J Primo Ms Od LLC | Organization | Optometrist | Covington, LA |
| 1639419328 | Mark Siverd Od LLC | Organization | Optometrist | Covington, LA |
| 1891136776 | Nicholas O'Connell | Individual | Pharmacist | Covington, LA |
| 1477954766 | Renee Gardebled | Individual | Pharmacist | Covington, LA |
Verify this record
Cross-check NPI 1245257583 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 2025-06-02.