WAL-MART STORES EAST LP - NPI 1083631279 - Pharmacy in Kingsport, TN

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

The NPI number for Wal-Mart Stores East LP is 1083631279. It was assigned to this organization in the NPPES registry on July 16, 2006. The provider is doing business as Walmart Pharmacy 10-0742.

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.

On this page

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 1083631279), doing business as Walmart Pharmacy 10-0742, is a healthcare organization registered as a community/retail pharmacy in Kingsport, Tennessee and active in the NPI registry since July 2006. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1083631279

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameWAL-MART STORES EAST LP

Location Address2500 W STONE DRKingsport, TN 37660-2356

Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 204-8550 · Fax (479) 277-4331

Phone(423) 245-0866

Fax(423) 245-8506

Organization SubpartNo

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

Enumeration DateJuly 16, 2006

Last NPPES UpdateJune 3, 20252 updates tracked since enumeration

NPPES CertifiedJune 3, 2025

✔ NPI 1083631279 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 TN · C2288

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

2500 W STONE DR, Kingsport, TN 37660

Open in Google Maps ↗

Other Names 1

Doing Business AsWalmart Pharmacy 10-0742

Other Identifiers 2

Medicaid1454061TN

Other2091298Pk

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 4

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.

74 services74 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.

70 services70 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

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.

11 services11 patients

Other Providers at the Same Location NPPES 7

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

THOMAS CLICK

Pharmacist