WAL-MART STORES EAST LP
NPI 1407250327
Pharmacy - Community/Retail Pharmacy in Miami, FL

Active since October 21, 2014CLIA 10D2180145 · Waiver
3200 NW 79TH ST, MIAMI, FL 33147(305) 913-8706(305) 913-8707 Get Directions Write a Review

NPPES record last updated: July 8, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 8, 2025, Feb 15, 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 1407250327), doing business as Walmart Pharmacy 10-4303, is a healthcare organization registered as a community/retail pharmacy in Miami, Florida and active in the NPI registry since October 2014. The organization holds a CLIA Waiver certificate valid through March 8, 2028 and lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1407250327
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address3200 NW 79TH STMiami, FL 33147-4600
Mailing Address702 Sw 8th St, Mailstop 0445Bentonville, AR 72716-0445 · (479) 277-2500 · Fax (479) 277-4331
Fax(305) 913-8707
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 853-0515
Enumeration DateOctober 21, 2014
Last NPPES UpdateJuly 8, 20252 updates tracked since enumeration
NPPES CertifiedJuly 8, 2025
NPI 1407250327 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 · PH28761
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
3200 NW 79TH ST, Miami, FL 33147

Other Names 1

Doing Business AsWalmart Pharmacy 10-4303

Other Identifiers 2

Medicaid014113500FL
Other2148794Pk

Accepted 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 10D2180145

Wal-Mart Stores East, LP · Miami, FL
Active · expires Mar 8, 2028
CLIA Number10D2180145
Laboratory TypePharmacy
Certificate Effective DateMarch 9, 2026
Certificate Expiration DateMarch 8, 2028
Laboratory DirectorIrina Cedeno
Laboratory Phone(305) 913-8706
Laboratory LocationWal-Mart Stores East, LP3200 NW 79th St, Miami, FL 33147
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 10-4303 carries, from the Medicare DMEPOS supplier directory.

Walmart Pharmacy 10-4303

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

Does not accept Medicare assignment

Walmart Pharmacy 10-4303 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)20503085
Medicare Participant SinceJuly 1, 2014
Supplier Location3200 NW 79th StMiami, FL 33147
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 9

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

Technician/Technologist (Optician)
3200 NW 79TH ST
MIAMI, FL 33147
Pharmacist
3200 NW 79TH ST
MIAMI, FL 33147
Eyewear Supplier
3200 NW 79TH ST
MIAMI, FL 33147
Optometrist
3200 NW 79TH ST
MIAMI, FL 33147
Pharmacist
3200 NW 79TH ST
MIAMI, FL 33147
Pharmacist
3200 NW 79TH ST
MIAMI, FL 33147
Technician/Technologist (Optician)
3200 NW 79TH ST
MIAMI, FL 33147
Technician/Technologist (Optician)
3200 NW 79TH ST
MIAMI, FL 33147

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 1407250327. It was assigned to this organization in the NPPES registry on October 21, 2014. The provider is doing business as Walmart Pharmacy 10-4303.

Where is Wal-Mart Stores East LP located?

Wal-Mart Stores East LP is located at 3200 NW 79th St, Miami, FL 33147. The listed phone number is (305) 913-8706.

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 10-4303 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.

Does Wal-Mart Stores East LP hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2180145) is associated with this NPI, valid through March 8, 2028. 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 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 July 8, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.