WAL-MART STORES EAST LP
NPI 1205944691
Pharmacy - Community/Retail Pharmacy in Miami Gardens, FL

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

The NPI number for Wal-Mart Stores East LP is 1205944691. It was assigned to this organization in the NPPES registry on August 27, 2006. The provider is doing business as Walmart Pharmacy 10-3311.

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.

Active since August 27, 2006CLIA 10D2188884 · Waiver

19501 NW 27TH AVE, MIAMI GARDENS, FL 33056(305) 622-6668(479) 277-4331 Get Directions Write a Review

NPPES record last updated: June 19, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 19, 2025, Jul 19, 2018, May 3, 2018 and 1 more (4 updates tracked since 2017).

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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 1205944691), doing business as Walmart Pharmacy 10-3311, is a healthcare organization registered as a community/retail pharmacy in Miami Gardens, Florida and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through July 22, 2028 and lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1205944691

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameWAL-MART STORES EAST LP

Location Address19501 NW 27TH AVEMiami Gardens, FL 33056-2521

Mailing Address702 Sw 8th StBentonville, AR 72716-0445

Phone(305) 622-6668

Fax(479) 277-4331

Organization SubpartNo

Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 853-0515

Enumeration DateAugust 27, 2006

Last NPPES UpdateJune 19, 20254 updates tracked since enumeration

NPPES CertifiedJune 19, 2025

✔ NPI 1205944691 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 · PH22176

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

19501 NW 27TH AVE, Miami Gardens, FL 33056

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Other Names 1

Doing Business AsWalmart Pharmacy 10-3311

Other Identifiers 3

Medicaid031655500FL

Medicaid031655501FL

Other2006893Pk

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 10D2188884

Wal-Mart Stores East, LP · Miami Gardens, FL

Active · expires Jul 22, 2028

CLIA Number10D2188884

Laboratory TypePharmacy

Certificate Effective DateJuly 23, 2026

Certificate Expiration DateJuly 22, 2028

Laboratory DirectorKiesha Zephirin-Belle

Laboratory Phone(305) 622-6668

Laboratory LocationWal-Mart Stores East, LP19501 NW 27th Ave, Miami Gardens, FL 33056

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Walmart Pharmacy 10-3311 carries, from the Medicare DMEPOS supplier directory.

Walmart Pharmacy 10-3311

DMEPOS supplier · Miami Gardens, FLOperated by Wal-Mart Stores East, LP

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Does not accept Medicare assignment

Walmart Pharmacy 10-3311 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)20497529

Medicare Participant SinceJuly 1, 2014

Supplier Location19501 NW 27th AveMiami Gardens, FL 33056

Phone(305) 622-6668

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 10

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

ASHLEY NICOLE WILLIAMS PHARMD

Pharmacist