WAL-MART STORES EAST LP NPI 1285071613

NPI Details

WAL-MART STORES EAST LP is a community/retail pharmacy pharmacy in Locust Grove, VA. The provider is 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. WAL-MART STORES EAST LP NPI is 1285071613. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

2533 GERMANNA HWY
LOCUST GROVE, VA
ZIP 22508-130
Phone: (540) 317-4508
Fax: (540) 317-4502

The provider's authorized official is Kimberly Canonic .
The authorized official title is Senior Director, Enrollment and has the following contact phone number (480) 853-0515.

The CLIA number assigned to this NPI record is 49D2130026 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count (HCPCS:K1034)
• Administration of influenza virus vaccine (HCPCS:G0008)
• Influenza vaccine split virus, preservative free (HCPCS:90662)
• Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)
• Fee covid-19 vac 14 res (HCPCS:0134A)
• Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use (HCPCS:90677)
• Adm sarscv2 30mcg trs-sucr 1 (HCPCS:0051A)
• Adm sarscv2 30mcg trs-sucr b (HCPCS:0054A)
• Administration of pneumococcal vaccine (HCPCS:G0009)
• Pneumococcal vaccine, 23-valent (HCPCS:90732)
• Adm sarscov2 100mcg/0.5ml3rd (HCPCS:0013A)

The enumeration date for this NPI number is 5/24/2013 and was last updated on 7/7/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.