| NPI | 1205926276 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-10-13 |
| Last Updated | 2025-06-19 |
| Authorized Official | Kimberly Canonic Senior Director, Enrollment Phone: 4808530515 |
| Mailing Address | 702 Sw 8th St Bentonville, AR 72716-0445 United States 📍 View Map |
| Primary Practice Address | 1580 Branan Field Rd Middleburg, FL 32068-8427 United States Phone: (904) 214-9115 | Fax: (479) 277-4331 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | FL | 031802700 | - |
| MEDICAID | FL | 031802701 | - |
| Other (non-Medicare) | - | 2007652 | PK |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 332B00000X – Durable Medical Equipment & Medical Supplies | - | - |
| Yes | 3336C0003X – Pharmacy, Community/Retail Pharmacy | FL | PH22330 |
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About NPI 1205926276
Wal-Mart Stores East Lp is an organization registered in the CMS NPPES NPI Registry with NPI number 1205926276. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Middleburg, FL. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-10-13. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1205926276?
NPI 1205926276 belongs to Wal-Mart Stores East Lp, a Pharmacy, Community/Retail Pharmacy in Middleburg, FL. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1205926276 active?
The current status of NPI 1205926276 in the NPPES registry is Active. The record was last updated on 2025-06-19.
What specialty is NPI 1205926276?
NPI 1205926276 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1205926276?
You can verify NPI 1205926276 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1205926276?
The primary practice address on file for NPI 1205926276 is 1580 Branan Field Rd, Middleburg, FL 32068-8427. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1205926276 issued?
NPI 1205926276 was first issued (enumerated) on 2006-10-13. The NPPES record was last updated on 2025-06-19.
Practice Location Map
Wal-Mart Stores East Lp is located at 1580 Branan Field Rd, Middleburg, FL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Wal-Mart Stores East Lp. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1205926276. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pharmacy, Community/Retail Pharmacy | PH22330 | FL |