Wal-Mart Stores East Lp
Wal-Mart Stores East Lp is a healthcare organization registered as Community/Retail Pharmacy in Cheboygan, MI, holding Type 2 (organization) NPI 1811914021 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1811914021 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores East Lp |
| Other name | <Unavail> |
| Practice address | 1150 S MAIN ST, Cheboygan, MI, 49721 |
| Phone | 2316274337 |
| Enumeration date | 2006-07-16 |
| Last updated in NPPES | 2025-06-04 |
Authorized official
| Name | Kimberly Canonic |
|---|---|
| Title | Senior Director, Enrollment |
| Phone | 4802776348 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 333600000X | Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 5301006121 | MI |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2042508 | Other | — | PK |
| 2353112 | Medicaid | MI | — |
Copy-ready billing details
Provider: Wal-Mart Stores East Lp NPI: 1811914021 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 1150 S MAIN ST, Cheboygan, MI, 49721
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1548341936 | Wal-Mart Stores East, Lp | Organization | Eyewear Supplier | Cheboygan, MI |
| 1811365067 | Kim Hendrix | Individual | Pharmacist | Cheboygan, MI |
| 1376993691 | Paul Reno | Individual | Pharmacist | Cheboygan, MI |
| 1154903987 | Heather Garst | Individual | Pharmacy Technician | Cheboygan, MI |
Verify this record
Cross-check NPI 1811914021 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?
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-06-04.