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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

WAL-MART STORES EAST, LP
NPI 1639093016
Pharmacy in Spring Hill, FL

Active since August 07, 2026CLIA 10D2347672 · Waiver
161 MARINER BLVD, SPRING HILL, FL 34609(352) 610-5733(352) 610-5722 Get Directions Write a Review

NPPES record added: August 7, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

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 1639093016), doing business as Walmart Pharmacy 10-3029, is a healthcare organization registered as a pharmacy in Spring Hill, Florida and active in the NPI registry since August 2026. The organization holds a CLIA Waiver certificate valid through July 21, 2028 and lists Kimberly Canonic, Director Of Health Care Contracting, as its authorized official.

NPPES Registry Identity

NPI1639093016
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWAL-MART STORES EAST, LP
Location Address161 MARINER BLVDSpring Hill, FL 34609-5625
Mailing Address1 Customer Dr # Ms 0445Bentonville, AR 72716-0445 · (479) 396-9842
Phone(352) 610-5733
Fax(352) 610-5722
Organization SubpartNo
Authorized OfficialKimberly CanonicDirector Of Health Care Contracting · (480) 853-0515
Enumeration DateAugust 7, 2026
NPPES CertifiedJuly 28, 2026
✔ NPI 1639093016 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
161 MARINER BLVD, Spring Hill, FL 34609
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Other Names 1

Doing Business AsWalmart Pharmacy 10-3029

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 10D2347672

Wal Mart Stores East LP · Spring Hill, FL
Active · expires Jul 21, 2028
CLIA Number10D2347672
Laboratory TypePharmacy
Certificate Effective DateJuly 22, 2026
Certificate Expiration DateJuly 21, 2028
Laboratory DirectorDavid Herrera Perez
Laboratory Phone(352) 610-5720
Laboratory LocationWal Mart Stores East LP161 Mariner Blvd, Spring Hill, FL 34609
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 1639093016. It was assigned to this organization in the NPPES registry on August 7, 2026. The provider is doing business as Walmart Pharmacy 10-3029.

Where is Wal-Mart Stores East, LP located?

Wal-Mart Stores East, LP is located at 161 Mariner Blvd, Spring Hill, FL 34609. The listed phone number is (352) 610-5733.

What is Wal-Mart Stores East, LP's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

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

Yes. A Certificate of Waiver (number 10D2347672) is associated with this NPI, valid through July 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wal-Mart Stores East, LP was last updated on August 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 48 days 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.