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Wal-Mart Stores East Lp

Pharmacy in Port St Lucie, FL · enumerated 2016 · authorized official Kimberly Canonic, Senior Director, Enrollment.

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

National Provider Identifier

1861859456

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Registry record

Entity type Organization (Type 2)
Legal business name Wal-Mart Stores East Lp
Other name <Unavail>
Practice address 902 Sw Saint Lucie West Blvd, Port St Lucie, FL, 34986
Phone (772) 446-8743
Enumeration date Jan 27, 2016
Last updated in NPPES Jun 9, 2025

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Secondary
333600000X Pharmacy Suppliers · License PH29886 (FL) Primary
3336C0003X Community/Retail Pharmacy Suppliers Secondary

Authorized official

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

Other identifiers

Identifier Type State Issuer
016828200 Medicaid AL -
2158085 Other - PK
016828201 DME Medicaid AL -

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

What is the NPI number for Wal-Mart Stores East Lp?
The NPI for Wal-Mart Stores East Lp is 1861859456, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Wal-Mart Stores East Lp?
NPPES lists Kimberly Canonic (Senior Director, Enrollment) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-06-09.