Wal-Mart Stores East Lp
Wal-Mart Stores East Lp is a healthcare organization registered as Community/Retail Pharmacy in Hernando, MS, holding Type 2 (organization) NPI 1790702116 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1790702116 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores East Lp |
| Other name | <Unavail> |
| Practice address | 2600 MCINGVALE RD, Hernando, MS, 38632 |
| Phone | 6624298767 |
| Enumeration date | 2006-07-16 |
| Last updated in NPPES | 2025-06-13 |
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 | 06499 | MS |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2047118 | Other | — | PK |
| 01529571 | Medicaid | MS | — |
| 1529571 | Medicaid | MS | — |
Copy-ready billing details
Provider: Wal-Mart Stores East Lp NPI: 1790702116 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 2600 MCINGVALE RD, Hernando, MS, 38632
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1306931597 | Henderson Vision Center | Organization | Optometrist | Hernando, MS |
| 1750467163 | Wal-Mart Stores East, Lp | Organization | Eyewear Supplier | Hernando, MS |
| 1972647519 | Kenya Henderson | Individual | Optometrist | Hernando, MS |
| 1639667678 | Karen Holley | Individual | Pharmacist | Hernando, MS |
| 1013405059 | Jody Fulper | Individual | Pharmacist | Hernando, MS |
| 1811582778 | Sherika Wheeler | Individual | Pharmacist | Hernando, MS |
Verify this record
Cross-check NPI 1790702116 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
Where is Wal-Mart Stores East Lp located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-06-13.