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WAL-MART STORES EAST LP
NPI 1073755724
Pharmacy - Community/Retail Pharmacy in Jacksonville, FL

Active since March 27, 2009CLIA 10D2283418 · Waiver
10251 SHOPS LN, JACKSONVILLE, FL 32258(904) 288-8189 Get Directions Write a Review

NPPES record last updated: July 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 11, 2025, Feb 16, 2017 (2 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 1073755724), doing business as Walmart Pharmacy 10-4444, is a healthcare organization registered as a community/retail pharmacy in Jacksonville, Florida and active in the NPI registry since March 2009. The organization holds a CLIA Waiver certificate valid through June 6, 2027 and lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1073755724
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address10251 SHOPS LNJacksonville, FL 32258-7406
Mailing Address702 Sw 8th St, Mail Stop 0445Bentonville, AR 72716-0445 · (479) 277-1242 · Fax (479) 277-4331
Phone(904) 288-8189
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 277-6348
Enumeration DateMarch 27, 2009
Last NPPES UpdateJuly 11, 20252 updates tracked since enumeration
NPPES CertifiedJuly 11, 2025
✔ NPI 1073755724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in FL · PH24028
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
10251 SHOPS LN, Jacksonville, FL 32258
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Other Names 1

Doing Business AsWalmart Pharmacy 10-4444

Other Identifiers 2

Medicaid001114700FL
Other2119685Pk

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 10D2283418

Wal-Mart Stores East LP · Jacksonville, FL
Active · expires Jun 6, 2027
CLIA Number10D2283418
Laboratory TypePharmacy
Certificate Effective DateJune 7, 2025
Certificate Expiration DateJune 6, 2027
Laboratory DirectorSandip J. Patel
Laboratory Phone(904) 288-8189
Laboratory LocationWal-Mart Stores East LP10251 Shops Ln, Jacksonville, FL 32258
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.
117 services117 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.
111 services111 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.
12 services12 patients

Other Providers at the Same Location NPPES 4

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

VICTORIA LUIZA PITTS
Technician/Technologist (Optician)
10251 SHOPS LN
JACKSONVILLE, FL 32258
Duval County (904) 288-8611
SANDIP JAYANTILAL PATEL
Pharmacist
10251 SHOPS LN
JACKSONVILLE, FL 32258
Duval County (904) 288-8189
WAL-MART STORES, INC.
Technician/Technologist (Optician)
10251 SHOPS LN
JACKSONVILLE, FL 32258
Duval County (904) 288-8211
MARK CHRISTOPHER WRIGHTMAN
Pharmacist
10251 SHOPS LN
JACKSONVILLE, FL 32258
Duval County (904) 288-8189

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 1073755724. It was assigned to this organization in the NPPES registry on March 27, 2009. The provider is doing business as Walmart Pharmacy 10-4444.

Where is Wal-Mart Stores East LP located?

Wal-Mart Stores East LP is located at 10251 Shops Ln, Jacksonville, FL 32258. The listed phone number is (904) 288-8189.

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 hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2283418) is associated with this NPI, valid through June 6, 2027. 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 50 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 July 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.