Wal-Mart Stores East Lp
Wal-Mart Stores East Lp is a healthcare organization registered as Community/Retail Pharmacy in Webster, NY, holding Type 2 (organization) NPI 1356368591 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1356368591 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores East Lp |
| Other name | <Unavail> |
| Practice address | 1902 EMPIRE BLVD, Webster, NY, 14580 |
| Phone | 5857871190 |
| Fax | 5857871192 |
| Enumeration date | 2006-07-16 |
| Last updated in NPPES | 2025-06-17 |
Authorized official
| Name | Kimberly Canonic |
|---|---|
| Title | Senior Director, Enrollment |
| Phone | 4808530515 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 333600000X | Pharmacy | Secondary | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 23363 | NY |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1266673 | Medicaid | NY | — |
| 2067151 | Other | — | PK |
Copy-ready billing details
Provider: Wal-Mart Stores East Lp NPI: 1356368591 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 1902 EMPIRE BLVD, Webster, NY, 14580
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1790898054 | Wal-Mart Stores East, Lp | Organization | Eyewear Supplier | Webster, NY |
| 1265611784 | Jian-Hua Fan | Individual | Pharmacist | Webster, NY |
| 1265754063 | Murray Notebaert | Individual | Pharmacist | Webster, NY |
| 1053633685 | Sandi Thide | Individual | Pharmacist | Webster, NY |
Verify this record
Cross-check NPI 1356368591 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
Who is the authorized official for Wal-Mart Stores East Lp?
What is the NPI number for Wal-Mart Stores East Lp?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-06-17.