Wal-Mart Stores East Lp is a Community/Retail Pharmacy (organization) practicing in Daytona Beach, Florida. The National Provider Identifier (NPI) is #1215948732, which was assigned on August 10, 2006, and the registration record was last updated on July 8, 2025. The practitioner's main practice location is at 1905 N Nova Rd, Daytona Beach, FL 32117-1421; the contact telephone number is 3866728955, and the fax number is 4792774331. The primary taxonomy of Wal-Mart Stores East Lp is Community/Retail Pharmacy (3336C0003X), with specialization in Community/Retail Pharmacy. The authorized official for Wal-Mart Stores East Lp is Kimberly Canonic (Senior Director, Enrollment). Wal-Mart Stores East Lp is licensed to practice in the state of Florida (#PH22245).
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.
| NPI | 1215948732 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Provider Name | WAL-MART STORES EAST LP |
| Practice Address |
1905 N Nova Rd Daytona Beach FL 32117-1421 |
| Practice Telephone | 3866728955 |
| Practice Fax Number | 4792774331 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Certification Date | 2025-07-08 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2025-07-08 |
| Is Organization Subpart | N |
| Official Name | KIMBERLY CANONIC |
| Official Title | SENIOR DIRECTOR, ENROLLMENT |
| Telephone | 4808530515 |
| Primary | Code | Classification | Specialization | Taxonomy Group | License Number | License State |
|---|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | ||||
| Y | 3336C0003X | Pharmacy | Community/Retail Pharmacy | PH22245 | FL |
| Other Identifier | Issuing State | Issuer | Identifier Type |
|---|---|---|---|
| 2007006 | PK | Other | |
| 031721700 | FL | MEDICAID |
| Other Organization Name | Type |
|---|---|
| WALMART PHARMACY 10-3862 | Doing Business As Name |
| Endpoint Type | Endpoint | Affiliation Legal Business Name | Affiliation Address | Use Description |
|---|---|---|---|---|
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Wal-Mart Stores East Lp | 4545 W 6th Ave, Stillwater, OK 74074-1523 | Durable Medical Equipment & Medical Supplies | 2006-12-27 |
| Wal-Mart Stores East Lp | 3581 Richland Ave W, Aiken, SC 29801-6311 | Durable Medical Equipment & Medical Supplies | 2007-07-19 |
| Wal-Mart Stores East Lp | 500 N Dobys Bridge Rd, Fort Mill, SC 29715-6815 | Pharmacy | 2015-10-08 |
| Wal-Mart Stores East Lp | 312 Palisades Blvd, Birmingham, AL 35209-5148 | Durable Medical Equipment & Medical Supplies | 2007-03-15 |
| Wal-Mart Stores East Lp | 10938 S Memorial Dr, Tulsa, OK 74133-7352 | Pharmacy | 2006-07-18 |
| Wal-Mart Stores East Lp | 1691 J A Cochran Byp, Chester, SC 29706-2204 | Durable Medical Equipment & Medical Supplies | 2006-07-18 |
| Wal-Mart Stores East Lp | 1007 Red Farmer Dr, Hueytown, AL 35023-1886 | Durable Medical Equipment & Medical Supplies | 2008-08-22 |
| Wal-Mart Stores East Lp | 3227 Old Forest Rd, Lynchburg, VA 24501-2325 | Community/Retail Pharmacy | 2010-05-13 |
| Wal-Mart Stores East Lp | 8800 E W T Harris Blvd, Charlotte, NC 28227-2402 | Durable Medical Equipment & Medical Supplies | 2014-04-30 |
| Wal-Mart Stores East Lp | 134 Daniel Kendall Dr, Brownsville, PA 15417-8303 | Community/Retail Pharmacy | 2012-11-20 |
| Find all providers with the same name | |||
| Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| Grouping | Suppliers |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| Classification | Durable Medical Equipment & Medical Supplies |
| Grouping | Suppliers |
| Definition: A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Wonder Care Pharmacy Inc. | 4407 Kissena Blvd, Flushing, NY 11355-3055 | Community/Retail Pharmacy | 2026-04-10 |
| Center for Family and Child Enrichment, Inc | 1825 Nw 167th St Ste 102, Miami Gardens, FL 33056-4838 | Community/Retail Pharmacy | 2026-04-10 |
| Home Town Pharmacy LLC | 1889 Commerce St, Yorktown Heights, NY 10598-4432 | Community/Retail Pharmacy | 2026-04-08 |
| Weis Markets Inc | 30250 Commerce Dr, Millsboro, DE 19966-3878 | Community/Retail Pharmacy | 2026-04-06 |
| Briar Hill Pharmacies LLC | 50 Union Ave, Irvington, NJ 07111-3262 | Community/Retail Pharmacy | 2026-04-09 |
| Community Health Center of Cape Cod, Inc. | 107 Commercial St, Mashpee, MA 02649-6507 | Community/Retail Pharmacy | 2026-04-07 |
| Douglas County Public Health Services Group, Inc. | 804 N Highway 5, Mansfield, MO 65704-7301 | Community/Retail Pharmacy | 2026-04-07 |
| Community Care Pharmacy LLC | 3065 W Bancroft St, Toledo, OH 43606-3353 | Community/Retail Pharmacy | 2026-04-10 |
| Grx Holdings LLC | 323 E Main St, Montezuma, IA 50171-4705 | Community/Retail Pharmacy | 2026-04-06 |
| Evolve Pharmacy LLC | 28037 Dequindre Rd Ste C, Madison Heights, MI 48071-3079 | Community/Retail Pharmacy | 2026-04-09 |
| Find all providers with the same taxonomy | |||
| Street Address |
1905 N NOVA RD |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32117-1421 |
| Country | US |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Kausar Parveen | 2381 Mason Ave Ste 100, Daytona Beach, FL 32117 | Internal Medicine Physician | 2005-10-20 |
| Georges Simple Solutions Inc | 1615 Ridgewood Ave Ste 102, Holly Hill, FL 32117-1749 | Attendant Care Provider | 2024-01-02 |
| Quick Care Medical | 645 Ridgewood Ave, Holly Hill, FL 32117-3617 | Primary Care Clinic/Center | 2005-09-19 |
| Tyra Hayes | 113 Notting Hill Dr, Daytona Beach, FL 32117-3832 | Driver | 2025-08-04 |
| Georges Simple Solutions Inc | 1615 Ridgewood Ave Ste 102, Holly Hill, FL 32117-1749 | Developmental Disabilities Clinic/Center | 2021-02-04 |
| Henri Habib Nammour | 2381 Mason Ave Suite 100, Daytona Beach, FL 32117 | Internal Medicine Physician | 2006-08-31 |
| Brianna Chana Williams | 1260 8th St, Daytona Beach, FL 32117-4009 | Private Vehicle | 2026-03-06 |
| A Masterful Win PLLC | 728 N Flamingo Dr, Daytona Beach, FL 32117-3332 | Psychiatric/Mental Health Nurse Practitioner | 2025-10-02 |
| Walgreen Co | 1829 Ridgewood Ave, Holly Hill, FL 32117-1737 | Community/Retail Pharmacy | 2006-07-29 |
| Tashena Beckford-Ng | 1963 Charleston House Way Apt 4306, Holly Hill, FL 32117-2588 | Home Health Agency | 2026-02-03 |
| Find all providers in the same zip code | |||
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Wal-Mart Stores, Inc. Dba Wal-Mart | 2500 S Main, Fort Scott, KS 66701 | Optician | 2007-03-08 |
| Wal-Mart Stores, Inc. Dba Wal-Mart | 2202 Pike Rd, Winfield, KS 67156-5400 | Optician | 2007-03-06 |
| Wal Mart Stores, Inc. Dba Wal-Mart | 31700 Grape Street, Lake Elsinore, CA 92530-9785 | Optician | 2006-10-02 |
| Wal Mart Stores, Inc. Dba Wal-Mart | 40580 Albrae St., Fremont, CA 94538-2448 | Optician | 2006-10-04 |
| Wal-Mart Stores, Inc. Dba Wal-Mart | 3900 Fountain Square Pl, Waukegan, IL 60085-6705 | Optician | 2007-02-28 |
| Wal Mart Stores, Inc. Dba Wal-Mart | 4255 Cy Avenue, Casper (W), WY 82604 | Optician | 2007-03-12 |
| Wal-Mart Stores, Inc. Dba Wal-Mart | 952 Swede Gulch Rd, Evergreen, CO 80401-9713 | Optician | 2007-03-08 |
| Wal-Mart Stores, Inc. Dba Wal-Mart | 1800 University Dr, Vista, CA 92083-7700 | Optician | 2007-03-09 |
| Wal-Mart Stores, Inc. Dba Wal-Mart | 825 Malerich Dr., Lincoln, IL 62656 | Optician | 2007-03-06 |
| Wal-Mart Stores, Inc. Dba Wal-Mart | 3205 Stower St, Miles City, MT 59301-5785 | Optician | 2007-03-12 |
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This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.
| Subject | Transparency and Disclosure |
| Jurisdiction | Federal |
| Data Provider | National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS) |
| Source | download.cms.gov |
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid). Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008. This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information. |