WAL-MART STORES EAST LP
NPI 1205853587
Pharmacy in Abingdon, MD

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

The NPI number for Wal-Mart Stores East LP is 1205853587. It was assigned to this organization in the NPPES registry on July 16, 2006. The provider is doing business as Walmart Pharmacy 10-2009.

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

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Active since July 16, 2006

401 CONSTANT FRIENDSHIP BLVD, ABINGDON, MD 21009(410) 569-9406(410) 569-9449 Get Directions Write a Review

NPPES record last updated: June 6, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 6, 2025, Jul 19, 2018, May 24, 2018 and 2 more (5 updates tracked since 2016).

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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 1205853587), doing business as Walmart Pharmacy 10-2009, is a healthcare organization registered as a pharmacy in Abingdon, Maryland and active in the NPI registry since July 2006. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1205853587

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameWAL-MART STORES EAST LP

Location Address401 CONSTANT FRIENDSHIP BLVDAbingdon, MD 21009-2566

Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 277-9170

Phone(410) 569-9406

Fax(410) 569-9449

Organization SubpartNo

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

Enumeration DateJuly 16, 2006

Last NPPES UpdateJune 6, 20255 updates tracked since enumeration

NPPES CertifiedJune 6, 2025

✔ NPI 1205853587 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in MD · P01778

Definition

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X

401 CONSTANT FRIENDSHIP BLVD, Abingdon, MD 21009

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Other Names 1

Doing Business AsWalmart Pharmacy 10-2009

Other Identifiers 2

Other2034798Pk

Medicaid469003600MD

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.

309 services305 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.

290 services287 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.

47 services47 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.

40 services40 patients

Medical Equipment Supplier Medicare DMEPOS 13

Medicare supplier enrollment and the product categories Walmart Stores East, LP carries, from the Medicare DMEPOS supplier directory.

Walmart Stores East, LP

DMEPOS supplier · Abingdon, MD

⋮

Does not accept Medicare assignment

Walmart Stores East, LP 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)20489591

Medicare Participant SinceJuly 1, 2014

Supplier Location401 Constant Friendship BlvdAbingdon, MD 21009

Phone(410) 569-9406

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

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

Blood Glucose Monitors/Supplies (Non-Mail Order)

Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

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Other Providers at the Same Location NPPES 6

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

MR. CLYDE LLOYD ROBERTS III

Pharmacist