Wal-Mart Stores East Lp
Wal-Mart Stores East Lp is a healthcare organization registered as Community/Retail Pharmacy in Everett, PA, holding Type 2 (organization) NPI 1497772545 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1497772545 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores East Lp |
| Other name | <Unavail> |
| Practice address | 72 BEDFORD SQ, Everett, PA, 15537 |
| Phone | 8146231995 |
| Enumeration date | 2006-07-16 |
| Last updated in NPPES | 2025-07-08 |
Authorized official
| Name | Kimberly Canonic |
|---|---|
| Title | Senior Director, Enrollment |
| Phone | 4808530515 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 333600000X | Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | PP414515L | PA |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007455310067 | Medicaid | PA | — |
| 2080947 | Other | — | PK |
Copy-ready billing details
Provider: Wal-Mart Stores East Lp NPI: 1497772545 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 72 BEDFORD SQ, Everett, PA, 15537
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1437384740 | Timothy Black | Individual | Pharmacist | Everett, PA |
| 1033719281 | Eric Lieb | Individual | Pharmacist | Everett, PA |
| 1730789371 | Lucetta Pontiff | Individual | Pharmacist | Everett, PA |
| 1801497326 | Heidi Hillegass | Individual | Pharmacist | Everett, PA |
| 1013678176 | Cheyenne Ware | Individual | Pharmacist | Everett, PA |
Verify this record
Cross-check NPI 1497772545 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?
Where is Wal-Mart Stores East Lp located?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-07-08.