WAL-MART STORES EAST LP
NPI 1356474480
Pharmacy - Community/Retail Pharmacy in Elizabethville, PA

Active since March 14, 2007
200 KOCHER LN, ELIZABETHVILLE, PA 17023(717) 362-4379 Get Directions Write a Review

NPPES record last updated: June 19, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 19, 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 1356474480), doing business as Wal-mart Pharmacy 10-3412, is a healthcare organization registered as a community/retail pharmacy in Elizabethville, Pennsylvania and active in the NPI registry since March 2007. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1356474480
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address200 KOCHER LNElizabethville, PA 17023-8716
Mailing Address702 Sw 8th StBentonville, AR 72716-0445
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 853-0515
Enumeration DateMarch 14, 2007
Last NPPES UpdateJune 19, 20252 updates tracked since enumeration
NPPES CertifiedJune 19, 2025
NPI 1356474480 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 PA · PP481688
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
200 KOCHER LN, Elizabethville, PA 17023

Other Names 1

Doing Business AsWal-mart Pharmacy 10-3412

Other Identifiers 2

Other2081767Pk
Medicaid1007455310248PA

Accepted 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.
129 services129 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.
124 services124 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.
13 services13 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.
13 services13 patients

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Walmart Pharmacy 10-3412 carries, from the Medicare DMEPOS supplier directory.

Walmart Pharmacy 10-3412

DMEPOS supplier · Elizabethville, PAOperated by Wal-Mart Stores East, LP

Does not accept Medicare assignment

Walmart Pharmacy 10-3412 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)20497163
Medicare Participant SinceJuly 1, 2014
Supplier Location200 Kocher LnElizabethville, PA 17023
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 5

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

Optometrist
200 KOCHER LN
ELIZABETHVILLE, PA 17023
Pharmacist
200 KOCHER LN
ELIZABETHVILLE, PA 17023
Pharmacist
200 KOCHER LN
ELIZABETHVILLE, PA 17023
Pharmacist
200 KOCHER LN
ELIZABETHVILLE, PA 17023
Pharmacist
200 KOCHER LN
ELIZABETHVILLE, PA 17023

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 1356474480. It was assigned to this organization in the NPPES registry on March 14, 2007. The provider is doing business as Wal-Mart Pharmacy 10-3412.

Where is Wal-Mart Stores East LP located?

Wal-Mart Stores East LP is located at 200 Kocher Ln, Elizabethville, PA 17023. The listed phone number is (717) 362-4379.

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 10-3412 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.

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 19, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.