Wal-Mart Stores East Lp
Wal-Mart Stores East Lp is a healthcare organization registered as Community/Retail Pharmacy in Onalaska, WI, holding Type 2 (organization) NPI 1629095773 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1629095773 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores East Lp |
| Other name | <Unavail> |
| Practice address | 3107 MARKET PL, Onalaska, WI, 54650 |
| Phone | 6087818355 |
| 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 | 8403-42 | WI |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2115184 | Other | — | PK |
| 33182000 | Medicaid | WI | — |
Copy-ready billing details
Provider: Wal-Mart Stores East Lp NPI: 1629095773 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 3107 MARKET PL, Onalaska, WI, 54650
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1063593176 | Wal-Mart Stores East, Lp | Organization | Eyewear Supplier | Onalaska, WI |
| 1194956748 | Onalaska Vision Associates, Inc. | Organization | Optometrist | Onalaska, WI |
| 1912318148 | Ann Mary Isacc | Individual | Pharmacotherapy Pharmacist | Onalaska, WI |
| 1386243681 | Tyler Sawall | Individual | Pharmacist | Onalaska, WI |
| 1447859434 | Sarah Davis | Individual | Pharmacist | Onalaska, WI |
| 1730788696 | Justin O'Driscoll | Individual | Pharmacist | Onalaska, WI |
| 1235738196 | Ruchi Patel | Individual | Pharmacist | Onalaska, WI |
| 1750980769 | Yan Gao | Individual | Pharmacist | Onalaska, WI |
Verify this record
Cross-check NPI 1629095773 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.