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Wal-Mart Stores East Lp

Community/Retail Pharmacy in Republic, MO · enumerated 2006 · authorized official Kimberly Canonic, Senior Director, Enrollment.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1407873755

Verified

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Registry record

Entity type Organization (Type 2)
Legal business name Wal-Mart Stores East Lp
Other name <Unavail>
Practice address 1150 Us Highway 60 E, Republic, MO, 65738
Phone (417) 732-1476
Enumeration date Jul 16, 2006
Last updated in NPPES Jun 4, 2025

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Secondary
333600000X Pharmacy Suppliers Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 2002009494 (MO) Primary

Authorized official

Name Kimberly Canonic
Title Senior Director, Enrollment
Phone (480) 277-6348

Other identifiers

Identifier Type State Issuer
602357006 Medicaid MO -
2050795 Other - PK

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.

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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 2025-06-04. Verify at npiregistry.cms.hhs.gov.
Where is Wal-Mart Stores East Lp located?
The practice location on file with NPPES is in Republic, MO.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-06-04.