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.

OrganizationActiveAccepts Medicare

Walmart Stores East Lp

NPI 1619424298 · Pharmacy · Derby, VT

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

Practice location

115 Seymour Drive

Derby, VT 05829-0000

Phone: (802) 624-8011

Fax: (802) 624-8010

Approximate (ZIP-level) locationGet directions

More VT providers

Mailing address

702 Sw 8th St

Bentonville, AR 72716-0445

Specialties & taxonomies

PharmacyPrimary333600000XLicense 038.0123545 (VT)
Suppliers
Durable Medical Equipment & Medical Supplies332B00000X
Suppliers
Community/Retail Pharmacy3336C0003X
Suppliers

Other names (DBA / former)

Doing business as: Walmart Pharmacy 10-4156

Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)

Profile Score

Established profile(70/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure28% of score
10 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.

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.

Provider details

Practice location

Mailing address

Specialties & taxonomies

Other names (DBA / former)

Profile Score

What this provider does (Medicare)

Registry dates

Frequently asked questions

Specialties & taxonomies

Other names (DBA / former)

Frequently asked questions

Profile Score

What this provider does (Medicare)