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WAL-MART STORES EAST LP
NPI 1053771386
Pharmacy - Community/Retail Pharmacy in Tupelo, MS

Active since February 29, 2016
316 S GLOSTER ST, TUPELO, MS 38801(662) 350-6920(662) 350-6919 Get Directions Write a Review

NPPES record last updated: June 18, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 18, 2025, Feb 15, 2017, Jan 18, 2017 and 4 more (7 updates tracked since 2016).

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 1053771386), doing business as Walmart Pharmacy 10-4619, is a healthcare organization registered as a community/retail pharmacy in Tupelo, Mississippi and active in the NPI registry since February 2016. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1053771386
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address316 S GLOSTER STTupelo, MS 38801-4748
Mailing Address702 Sw 8th St, Ms 0445Bentonville, AR 72716-0445 · (479) 204-8550 · Fax (479) 277-4331
Phone(662) 350-6920
Fax(662) 350-6919
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 853-0515
Enumeration DateFebruary 29, 2016
Last NPPES UpdateJune 18, 20257 updates tracked since enumeration
NPPES CertifiedJune 18, 2025
✔ NPI 1053771386 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 MS · 14710/1.2
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 ListedPharmacyTaxonomy 333600000X
316 S GLOSTER ST, Tupelo, MS 38801
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Other Names 1

Doing Business AsWalmart Pharmacy 10-4619

Other Identifiers 2

Other2158941Pk
Medicaid03929751MS

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 ›

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
83 services83 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
77 services77 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
14 services14 patients

Medical Equipment Supplier Medicare DMEPOS 11

Medicare supplier enrollment and the product categories Walmart Pharmacy 10-4619 carries, from the Medicare DMEPOS supplier directory.

Walmart Pharmacy 10-4619

DMEPOS supplier · Tupelo, MSOperated by Wal-Mart Stores East, LP
⋮

Does not accept Medicare assignment

Walmart Pharmacy 10-4619 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)20497901
Medicare Participant SinceJuly 1, 2014
Supplier Location316 S Gloster StTupelo, MS 38801
Phone(662) 350-6920
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 5

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

SARAH KATHRYN MORRIS
Pharmacist
316 S GLOSTER ST
TUPELO, MS 38801
Lee County (662) 350-6921
ABBY KENSINGTON PITTS PHARMD
Pharmacist
316 S GLOSTER ST
TUPELO, MS 38801
Lee County (662) 350-6920
ZOE THORNTON
Pharmacist
316 S GLOSTER ST
TUPELO, MS 38801
Lee County (662) 350-6921
LESLIE BROOKE BROOKS PHARM. D.
Pharmacist
316 S GLOSTER ST
TUPELO, MS 38801
Lee County (662) 350-6920
BLAKE SMITH
Pharmacist
316 S GLOSTER ST
TUPELO, MS 38801
Lee County (662) 350-6921

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 1053771386. It was assigned to this organization in the NPPES registry on February 29, 2016. The provider is doing business as Walmart Pharmacy 10-4619.

Where is Wal-Mart Stores East LP located?

Wal-Mart Stores East LP is located at 316 S Gloster St, Tupelo, MS 38801. The listed phone number is (662) 350-6920.

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, Walmart Pharmacy 10-4619 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.

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 53 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 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.