Wal-mart Stores East Lp
Community/Retail Pharmacy
4024 Elkhart Rd Ste 2, Goshen
Indiana, 46526-5801
574-875-6921 Wal-mart Stores East Lp is a Community/Retail Pharmacy in Goshen, Indiana. It is located at 4024 Elkhart Rd Ste 2, Goshen and it's customer support contact number is 574-875-6921. The authorized person of Wal-mart Stores East Lp is Kimberly Canonic who is Senior Director, Enrollment of the pharmacy and his contact number is 480-277-6348. Active license number of Wal-mart Stores East Lp is 60005066A for Community/Retail Pharmacy in Indiana. Wal-mart Stores East Lp accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Wal-mart Stores East Lp 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.
Pharmacy Details:
Wal-mart Stores East Lp type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Wal-mart Stores East Lp |
| Type: | Community/Retail Pharmacy |
| Location: | 4024 Elkhart Rd Ste 2, Goshen,
Indiana, 46526-5801 |
| Phone: | 574-875-6921 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Kimberly Canonic |
| Position: | Senior Director, Enrollment |
| Contact Number: | 480-277-6348 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1972522951 |
| NPI Enumeration Date: | 19 Jul, 2006 |
| NPI Last Update On: | 11 Jul, 2025 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Wal-mart Stores East Lp are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | 60005066A | Indiana | Primary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
| Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 2027119 | Other | | Pk |
| 100295570A | Medicaid | Indiana | |
| 100295570 | Medicaid | Indiana | |
Medicare Enrollment:
Wal-mart Stores East Lp is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 6204749997 | O20100930057915 | Wal-mart Stores East Lp | DME SUPPLIER - PHARMACY |
Products Available:
Wal-mart Stores East Lp has following products available for sale under medicare.
| Products: |
|---|
| • Blood Glucose Monitors & Supplies: Mail Order | • Blood Glucose Monitors & Supplies: Non-mail Order |
| • Canes & Crutches | • Enteral Nutrients |
| • Ostomy Supplies | • Prosthetic Lenses: Conventional Contact Lenses |
| • Prosthetic Lenses: Conventional Eyeglasses | • Surgical Dressings |
| • Walkers | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 702 Sw 8th St, Mail Stop 0445
Bentonville, Arkansas |
| Zip: | 72716-0445 |
| Phone Number: | 479-277-1242 |
Patients can reach Wal-mart Stores East Lp at
4024 Elkhart Rd Ste 2, Goshen, Indiana or can
call on customer care at 574-875-6921.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.