Walmart Stores East Lp
NPI 1619424298 · Pharmacy · Derby, VT
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Walmart Stores East Lp is a Pharmacy organization in Derby, VT (NPI 1619424298).
Provider details
- NPI number
- 1619424298
- Entity type
- Organization
- Primary specialty
- PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Kimberly Canonic, Senior Director, Enrollment(480) 277-6348
Specialties & taxonomies
Suppliers
Suppliers
- Community/Retail Pharmacy3336C0003X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
9 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
574 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. 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.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Admn Sarscov2 Vacc 1 Dose90480 | 277 | $10 |
| Administration of Influenza Virus VaccineG0008 | 264 | $21 |
| Administration of Pneumococcal VaccineG0009 | 33 | $19 |
Typical Medicare-allowed amounts for these services range $10–$21 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Walmart Pharmacy 10-4156
Registry dates
- Enumerated
- 2016-09-01
- Last updated
- 2025-06-05
- Certified
- 2025-06-05
Frequently asked questions
- What is Walmart Stores East Lp's NPI number?
- Walmart Stores East Lp's National Provider Identifier (NPI) is 1619424298, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Walmart Stores East Lp?
- Walmart Stores East Lp is classified in the NPPES registry as Pharmacy (Suppliers).
- Where is Walmart Stores East Lp located?
- Walmart Stores East Lp's practice location on file with NPPES is 115 Seymour Drive, Derby, VT 05829-0000.
- What is Walmart Stores East Lp's phone number?
- The practice phone number listed in the NPPES registry for Walmart Stores East Lp is (802) 624-8011.
- Does Walmart Stores East Lp accept Medicare?
- Walmart Stores East Lp is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Walmart Stores East Lp?
- The authorized official listed on Walmart 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 Walmart Stores East Lp's NPI active?
- Yes — Walmart Stores East Lp's NPI (1619424298) is active in the NPPES registry as of the last update on 2025-06-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.