OrganizationActive
Wal-Mart Stores East Lp
NPI 1053747071 · Community/Retail Pharmacy · Princeton, IN
Wal-Mart Stores East Lp is a Community/Retail Pharmacy organization in Princeton, IN (NPI 1053747071).
Provider details
- NPI number
- 1053747071
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Kimberly Canonic, Senior Director, Enrollment(480) 277-6348
Specialties & taxonomies
Suppliers
Suppliers
- Institutional Pharmacy3336I0012X
Suppliers
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4924 S Maple Tree Dr
Princeton, IN 47670-9278
Phone: (812) 385-0757
Fax: (812) 385-0759
Approximate (ZIP-level) locationGet directions
Mailing address
702 Sw 8th St
Bentonville, AR 72716-0445
Other names (DBA / former)
- Doing business as
- Walmart Pharmacy 10-7266
Registry dates
- Enumerated
- 2013-09-23
- Last updated
- 2025-06-10
- Certified
- 2025-06-10
Frequently asked questions
- What is Wal-Mart Stores East Lp's NPI number?
- Wal-Mart Stores East Lp's National Provider Identifier (NPI) is 1053747071, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Wal-Mart Stores East Lp?
- Wal-Mart Stores East Lp is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Wal-Mart Stores East Lp located?
- Wal-Mart Stores East Lp's practice location on file with NPPES is 4924 S Maple Tree Dr, Princeton, IN 47670-9278.
- What is Wal-Mart Stores East Lp's phone number?
- The practice phone number listed in the NPPES registry for Wal-Mart Stores East Lp is (812) 385-0757.
- Who is the authorized official for Wal-Mart Stores East Lp?
- The authorized official listed on Wal-Mart Stores East Lp's NPPES record is Kimberly Canonic, Senior Director, Enrollment. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Wal-Mart Stores East Lp's NPI active?
- Yes — Wal-Mart Stores East Lp's NPI (1053747071) is active in the NPPES registry as of the last update on 2025-06-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.