WAL-MART STORES EAST LP
NPI 1144564782
Pharmacy - Community/Retail Pharmacy in Newport News, VA

Active since November 20, 2012CLIA 49D2118624 · Waiver
6111 JEFFERSON AVE, NEWPORT NEWS, VA 23605(757) 637-4217 Get Directions Write a Review

NPPES record last updated: June 18, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 18, 2025, Feb 15, 2017, Dec 13, 2016 (3 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 1144564782), doing business as Walmart Pharmacy 10-4623, is a healthcare organization registered as a community/retail pharmacy in Newport News, Virginia and active in the NPI registry since November 2012. The organization holds a CLIA Waiver certificate valid through September 11, 2026 and lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1144564782
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address6111 JEFFERSON AVENewport News, VA 23605-1511
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 204-0709 · Fax (479) 277-4331
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 853-0515
Enumeration DateNovember 20, 2012
Last NPPES UpdateJune 18, 20253 updates tracked since enumeration
NPPES CertifiedJune 18, 2025
NPI 1144564782 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License Licensed in VA · 0201004494
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.

6111 JEFFERSON AVE, Newport News, VA 23605

Other Names 1

Doing Business AsWalmart Pharmacy 10-4623

Other Identifiers 2

Medicaid1144564782VA
Other2138057Pk

Accepted 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 49D2118624

Wal-Mart Stores East, LP Wal-Mart Pharmacy #10-4623 · Newport News, VA
Active · expires Sep 11, 2026
CLIA Number49D2118624
Laboratory TypePharmacy
Certificate Effective DateSeptember 12, 2024
Certificate Expiration DateSeptember 11, 2026
Laboratory DirectorChristine Gular
Laboratory Phone(479) 256-6734
Laboratory LocationWal-Mart Stores East, LP Wal-Mart Pharmacy #10-46236111 Jefferson Avenue, Newport News, VA 23605
CLIA data matches this NPI record on: Address Name
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.
77 services75 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.
66 services65 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

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Walmart Pharmacy 10-4623 carries, from the Medicare DMEPOS supplier directory.

Walmart Pharmacy 10-4623

DMEPOS supplier · Newport News, VAOperated by Wal-Mart Stores East, LP

Does not accept Medicare assignment

Walmart Pharmacy 10-4623 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)20502941
Medicare Participant SinceJuly 1, 2014
Supplier Location6111 Jefferson AveNewport News, VA 23605
Supplier Specialties
Pharmacy Optician

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 8

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

Eyewear Supplier
6111 JEFFERSON AVE
NEWPORT NEWS, VA 23605
Optometrist
6111 JEFFERSON AVE
NEWPORT NEWS, VA 23605
Pharmacist
6111 JEFFERSON AVE
NEWPORT NEWS, VA 23605
Pharmacist
6111 JEFFERSON AVE
NEWPORT NEWS, VA 23605
Pharmacist
6111 JEFFERSON AVE
NEWPORT NEWS, VA 23605
Pharmacist
6111 JEFFERSON AVE
NEWPORT NEWS, VA 23605
Pharmacist
6111 JEFFERSON AVE
NEWPORT NEWS, VA 23605
Technician/Technologist (Optician)
6111 JEFFERSON AVE
NEWPORT NEWS, VA 23605

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 1144564782. It was assigned to this organization in the NPPES registry on November 20, 2012. The provider is doing business as WalMart Pharmacy 10-4623.

Where is Wal-Mart Stores East LP located?

Wal-Mart Stores East LP is located at 6111 Jefferson Ave, Newport News, VA 23605. The listed phone number is (757) 637-4217.

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 10-4623 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 49D2118624) is associated with this NPI, valid through September 11, 2026. 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 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.