WAL-MART STORES EAST LP
NPI 1265700231
Pharmacy - Community/Retail Pharmacy in Atlanta, GA

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

The NPI number for Wal-Mart Stores East LP is 1265700231. It was assigned to this organization in the NPPES registry on December 6, 2011. The provider is doing business as WalMart Pharmacy 10-5010.

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 December 06, 2011

1030 DELTA BLVD, ATLANTA, GA 30354(404) 305-8890 Get Directions Write a Review

NPPES record last updated: June 6, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 6, 2025, Feb 16, 2017, Dec 16, 2016 and 1 more (4 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 1265700231), doing business as Walmart Pharmacy 10-5010, is a healthcare organization registered as a community/retail pharmacy in Atlanta, Georgia and active in the NPI registry since December 2011. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1265700231

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameWAL-MART STORES EAST LP

Location Address1030 DELTA BLVDAtlanta, GA 30354-1989

Mailing Address702 Sw 8th StBentonville, AR 72716-6209 · (479) 277-1242 · Fax (479) 277-4331

Phone(404) 305-8890

Organization SubpartNo

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

Enumeration DateDecember 6, 2011

Last NPPES UpdateJune 6, 20254 updates tracked since enumeration

NPPES CertifiedJune 6, 2025

✔ NPI 1265700231 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 GA · PHRE009794

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

1030 DELTA BLVD, Atlanta, GA 30354

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Other Names 1

Doing Business AsWalmart Pharmacy 10-5010

Other Identifiers 2

Other2132938Pk

Medicaid003133460AGA

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 ›

Medical Equipment Supplier Medicare DMEPOS 10

Medicare supplier enrollment and the product categories Walmart Pharmacy 10-5010 carries, from the Medicare DMEPOS supplier directory.

Walmart Pharmacy 10-5010

DMEPOS supplier · Atlanta, GAOperated by Wal-Mart Stores East, LP

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Does not accept Medicare assignment

Walmart Pharmacy 10-5010 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)20497643

Medicare Participant SinceJuly 1, 2014

Supplier Location1030 Delta BlvdAtlanta, GA 30354

Phone(404) 305-8890

Supplier Specialties

Pharmacy

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.

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.

JENYCE LANE ATC

Specialist/Technologist (Athletic Trainer)