Wal-Mart Stores East Lp
Wal-Mart Stores East Lp is a healthcare organization registered as Community/Retail Pharmacy in Bowling Green, KY, holding Type 2 (organization) NPI 1902823321 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1902823321 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores East Lp |
| Other name | <Unavail> |
| Practice address | 150 WALTON AVE, Bowling Green, KY, 42104 |
| Phone | 2707829785 |
| Enumeration date | 2006-07-16 |
| Last updated in NPPES | 2025-05-29 |
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 | PO1794 | KY |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5401958300 | Medicaid | KY | — |
| 2030544 | Other | — | PK |
| 5400754700 | Medicaid | KY | — |
Copy-ready billing details
Provider: Wal-Mart Stores East Lp NPI: 1902823321 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 150 WALTON AVE, Bowling Green, KY, 42104
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1164512687 | Wal-Mart Stores East, Lp | Organization | Eyewear Supplier | Bowling Green, KY |
| 1902961089 | James Raley | Individual | Optometrist | Bowling Green, KY |
| 1780284208 | Jeffrey Rowland | Individual | Pharmacist | Bowling Green, KY |
| 1861092660 | Margann Boyles | Individual | Pharmacist | Bowling Green, KY |
| 1427658210 | Timothy Byrd | Individual | Pharmacist | Bowling Green, KY |
| 1801525217 | Ashley Dunn | Individual | Optician | Bowling Green, KY |
| 1710616131 | Della Gaskin | Individual | Optician | Bowling Green, KY |
| 1629707963 | Melanie Arnold | Individual | Optician | Bowling Green, KY |
Verify this record
Cross-check NPI 1902823321 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?
What is the NPI number for Wal-Mart Stores East Lp?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-05-29.