1. Home
  2. Directory
  3. Florida
  4. Port Charlotte
  5. Pharmacy
  6. NPI Profile

WAL-MART STORES EAST LP
NPI 1306863618
Pharmacy - Community/Retail Pharmacy in Port Charlotte, FL

Active since July 16, 2006CLIA 10D2189899 · Waiver
19100 MURDOCK CIR, PORT CHARLOTTE, FL 33948(941) 625-8825 Get Directions Write a Review

NPPES record last updated: June 3, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 3, 2025, Feb 16, 2017 (2 updates tracked since 2017).

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 1306863618), doing business as Walmart Pharmacy 10-0721, is a healthcare organization registered as a community/retail pharmacy in Port Charlotte, Florida and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through August 5, 2026 and lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1306863618
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address19100 MURDOCK CIRPort Charlotte, FL 33948-1022
Mailing Address702 Sw 8th StBentonville, AR 72716-0445
Phone(941) 625-8825
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 1306863618 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 FL · PH15350
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
19100 MURDOCK CIR, Port Charlotte, FL 33948
Open in Google Maps ↗

Other Names 1

Doing Business AsWalmart Pharmacy 10-0721

Other Identifiers 2

Other2007580Pk
Medicaid101592300FL

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 10D2189899

Wal-Mart Stores East, LP · Port Charlotte, FL
Active · expires Aug 5, 2026
CLIA Number10D2189899
Laboratory TypePharmacy
Certificate Effective DateAugust 6, 2024
Certificate Expiration DateAugust 5, 2026
Laboratory DirectorKelli Boley
Laboratory Phone(941) 625-8825
Laboratory LocationWal-Mart Stores East, LP19100 Murdock Circle, Port Charlotte, FL 33948
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.
230 services229 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.
214 services214 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.
46 services46 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.
25 services25 patients

Other Providers at the Same Location NPPES 4

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

JAMES B COPPOLA OD
Optometrist
19100 MURDOCK CIR
PORT CHARLOTTE, FL 33948
Charlotte County (941) 625-7437
WAL-MART STORES EAST, LP
Eyewear Supplier
19100 MURDOCK CIR
PORT CHARLOTTE, FL 33948
Charlotte County (941) 625-2399
MRS. THERESA YVONNE MARTINEZ ABOC, NCLEC
Technician/Technologist (Optician)
19100 MURDOCK CIR, VISION CENTER
PORT CHARLOTTE, FL 33948
Charlotte County (941) 625-7437
JENNIFER THRALL
Pharmacist
19100 MURDOCK CIR
PORT CHARLOTTE, FL 33948
Charlotte County (941) 625-8825

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 1306863618. It was assigned to this organization in the NPPES registry on July 16, 2006. The provider is doing business as Walmart Pharmacy 10-0721.

Where is Wal-Mart Stores East LP located?

Wal-Mart Stores East LP is located at 19100 Murdock Cir, Port Charlotte, FL 33948. The listed phone number is (941) 625-8825.

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 hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2189899) is associated with this NPI, valid through August 5, 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 50 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 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.