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WAL-MART STORES EAST LP
NPI 1790703122
Pharmacy - Community/Retail Pharmacy in Gibsonton, FL

Active since July 17, 2006CLIA 10D2180165 · Waiver
9205 GIBSONTON DR, GIBSONTON, FL 33534(813) 672-4932(479) 277-4331 Get Directions Write a Review

NPPES record last updated: June 13, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 13, 2025, May 11, 2023, Jul 19, 2018 and 3 more (6 updates tracked since 2016).

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 1790703122), doing business as Walmart Pharmacy 10-5300, is a healthcare organization registered as a community/retail pharmacy in Gibsonton, Florida and active in the NPI registry since July 2006. 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

NPI1790703122
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address9205 GIBSONTON DRGibsonton, FL 33534-4608
Mailing Address702 Sw 8th StBentonville, AR 72716-0445
Phone(813) 672-4932
Fax(479) 277-4331
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 853-0515
Enumeration DateJuly 17, 2006
Last NPPES UpdateJune 13, 20256 updates tracked since enumeration
NPPES CertifiedJune 13, 2025
✔ NPI 1790703122 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in FL · PH21888
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
Also ListedPharmacy · Specialty PharmacyTaxonomy 3336S0011X
9205 GIBSONTON DR, Gibsonton, FL 33534
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Other Names 1

Doing Business AsWalmart Pharmacy 10-5300

Other Identifiers 3

Other2006414Pk
Medicaid031366100FL
MedicaidPH21888FL

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 10D2180165

Wal-Mart Store East, LP · Gibsonton, FL
Active · expires Mar 8, 2028
CLIA Number10D2180165
Laboratory TypePharmacy
Certificate Effective DateMarch 9, 2026
Certificate Expiration DateMarch 8, 2028
Laboratory DirectorNishaben Patel
Laboratory Phone(813) 672-4932
Laboratory LocationWal-Mart Store East, LP9205 Gibsonton Dr, Gibsonton, FL 33534
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

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.
37 services35 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.
32 services30 patients

Other Providers at the Same Location NPPES 2

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

NISHABEN B PATEL
Pharmacist
9205 GIBSONTON DR
GIBSONTON, FL 33534
Hillsborough County (813) 672-4932
WAL-MART STORES EAST, LP
Eyewear Supplier
9205 GIBSONTON DR
GIBSONTON, FL 33534
Hillsborough County (813) 741-1034

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 1790703122. It was assigned to this organization in the NPPES registry on July 17, 2006. The provider is doing business as Walmart Pharmacy 10-5300.

Where is Wal-Mart Stores East LP located?

Wal-Mart Stores East LP is located at 9205 Gibsonton Dr, Gibsonton, FL 33534. The listed phone number is (813) 672-4932.

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 10D2180165) 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 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 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.