WAL-MART STORES EAST LP - NPI 1073983557

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

The NPI number for Wal-Mart Stores East LP is 1073983557. It was assigned to this organization in the NPPES registry on September 28, 2015. The provider is doing business as Walmart Pharmacy 10-6469.

Q: 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.

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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 1073983557), doing business as Walmart Pharmacy 10-6469, is a healthcare organization registered as a community/retail pharmacy in Byram, Mississippi and active in the NPI registry since September 2015. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1073983557

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameWAL-MART STORES EAST LP

Location Address131 HANDLEY BLVDByram, MS 39272-8983

Mailing Address702 Sw 8th StBentonville, AR 72716-6209 · (479) 204-8550 · Fax (479) 277-4331

Phone(769) 237-4059

Fax(769) 237-4058

Organization SubpartNo

Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 277-6348

Enumeration DateSeptember 28, 2015

Last NPPES UpdateJune 9, 20257 updates tracked since enumeration

NPPES CertifiedJune 9, 2025

✔ NPI 1073983557 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 MS · 14480

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

131 HANDLEY BLVD, Byram, MS 39272

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Other Names 1

Doing Business AsWalmart Pharmacy 10-6469

Other Identifiers 2

Other2154957Pk

Medicaid01000736MS

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 5

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.

118 services115 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.

114 services111 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

19 services19 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.

19 services19 patients

Severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5ml dosage, for intramuscular use 91304

The COVID-19 vaccine you'll receive is designed to protect against the virus. It contains tiny, harmless pieces of the virus's spike protein. These trigger your immune system to build a defense. The vaccine also includes a saponin-based adjuvant to enhance this response. It's given as a 0.5ml injection into a muscle.

18 services18 patients

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.

WAL-MART STORES EAST LP

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