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WAL-MART STORES EAST LP
NPI 1053710566
Pharmacy - Community/Retail Pharmacy in Miami Gardens, FL

Active since August 20, 2014CLIA 10D2180146 · Waiver
3791 NW 167TH ST, MIAMI GARDENS, FL 33055(305) 914-1974(305) 914-1869 Get Directions Write a Review

NPPES record last updated: June 9, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 9, 2025, May 11, 2023, Feb 15, 2017 (3 updates tracked since 2017).

About Wal-mart Stores East Lp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WAL-MART STORES EAST LP (NPI 1053710566), doing business as Walmart Pharmacy 10-2907, is a healthcare organization registered as a community/retail pharmacy in Miami Gardens, Florida and active in the NPI registry since August 2014. The organization holds a CLIA Waiver certificate valid through March 8, 2028 and lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1053710566
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address3791 NW 167TH STMiami Gardens, FL 33055-4510
Mailing Address702 Sw 8th StBentonville, AR 72716-6209 · (479) 277-2500 · Fax (479) 277-4331
Phone(305) 914-1974
Fax(305) 914-1869
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 277-6348
Enumeration DateAugust 20, 2014
Last NPPES UpdateJune 9, 20253 updates tracked since enumeration
NPPES CertifiedJune 9, 2025
✔ NPI 1053710566 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in FL · PH28752
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Specialty PharmacyTaxonomy 3336S0011X
3791 NW 167TH ST, Miami Gardens, FL 33055
Open in Google Maps ↗

Other Names 1

Doing Business AsWalmart Pharmacy 10-2907

Other Identifiers 2

Other2148675Pk
Medicaid014059200FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2180146

Wal-Mart Stores East, LP · Miami Gardens, FL
Active · expires Mar 8, 2028
CLIA Number10D2180146
Laboratory TypePharmacy
Certificate Effective DateMarch 9, 2026
Certificate Expiration DateMarch 8, 2028
Laboratory DirectorSheila Goodman
Laboratory Phone(305) 914-1974
Laboratory LocationWal-Mart Stores East, LP3791 NW 167th Street, Miami Gardens, FL 33055
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 11

Medicare supplier enrollment and the product categories Wal-Mart Stores East, LP carries, from the Medicare DMEPOS supplier directory.

Wal-Mart Stores East, LP

DMEPOS supplier · Miami Gardens, FL
⋮

Does not accept Medicare assignment

Wal-Mart Stores East, LP has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20503127
Medicare Participant SinceJuly 1, 2014
Supplier Location3791 NW 167th StMiami Gardens, FL 33055
Phone(305) 914-1974
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SHELIA GOODMAN PHARMD
Pharmacist
3791 NW 167TH ST
MIAMI GARDENS, FL 33055
Miami-Dade County (305) 914-1975
VALENCIA CULMER RPH
Pharmacist
3791 NW 167TH ST
MIAMI GARDENS, FL 33055
Miami-Dade County (305) 914-1974
JEISSA LIZANDRA CONCEPCION PHARMD
Pharmacist
3791 NW 167TH ST
MIAMI GARDENS, FL 33055
Miami-Dade County (305) 914-1974

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wal-Mart Stores East LP's NPI number?

The NPI number for Wal-Mart Stores East LP is 1053710566. It was assigned to this organization in the NPPES registry on August 20, 2014. The provider is doing business as Walmart Pharmacy 10-2907.

Where is Wal-Mart Stores East LP located?

Wal-Mart Stores East LP is located at 3791 NW 167th St, Miami Gardens, FL 33055. The listed phone number is (305) 914-1974.

What is Wal-Mart Stores East LP's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Wal-Mart Stores East LP accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Wal-Mart Stores East, LP does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Wal-Mart Stores East LP hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2180146) is associated with this NPI, valid through March 8, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Wal-Mart Stores East LP accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 49 other insurers list Wal-Mart Stores East LP as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wal-Mart Stores East LP was last updated on June 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.