WAL-MART STORES EAST LP – NPI #1568984912
Pharmacy

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.

Health Care Provider Taxonomy Code for Pharmacy

WAL-MART STORES EAST LP is a pharmacy located in CUMMING, GA. NPPES has assigned the NPI number 1568984912 to WAL-MART STORES EAST LP on July 07, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 3336C0003X from the Health Care Provider Taxonomy code set, which is classified as Pharmacy, specializing in Community/Retail Pharmacy

The NPI profile was last updated on Jun 09, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for WAL-MART STORES EAST LP below.

NPI Profile for
WAL-MART STORES EAST LP

NPI Number
1568984912
Enumeration Date

(about 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
WAL-MART STORES EAST LP
Primary location
3655 BROWNS BRIDGE RD
CUMMING, GA 30028
Phone: (479) 277-2500 Fax:
Mailing address
702 SW 8TH ST # MS 0445
BENTONVILLE, AR 72716-0445
Phone: (479) 277-2500 Fax: (479) 277-4331
Organization Subpart
No
Authorized Official
KIMBERLY CANONIC
SENIOR DIRECTOR, ENROLLMENT
Phone: (480) 277-6348
Updated
Certification Date
Jun 09, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
3336C0003X
- Pharmacy / Community/Retail Pharmacy (Primary)
332B00000X
- Durable Medical Equipment & Medical Supplies

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Endpoint type
CONNECT URL
Endpoint Description
2.16.840.1.113883.3.667.2
Content Type
Affiliation
Y
Endpoint Location
100 N 6TH ST STE 900A,
MINNEAPOLIS, MN 77025-1669