National Provider Identifier
Wal-Mart Stores East LP
Wal-Mart Stores East LP is listed in the NPPES registry with a primary specialty of Community/Retail Pharmacy in Rochester, NY and a listed phone number of (585) 266-1640.
Source: public NPPES record, last updated June 18, 2025. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.
Profile Overview
- NPI
- 1225055395
- Provider Type
- Organization
- Primary Specialty
- Community/Retail Pharmacy
- Enumeration Date
- July 16, 2006
- Last Updated
- June 18, 2025
Practice Location
- 1490 Hudson Ave
- Rochester, NY 14621-1701
Phone: (585) 266-1640
Mailing Address
- 702 Sw 8Th St
- Bentonville, AR 72716-0445
Authorized Official
- Name
- Kimberly Canonic
- Title
- Senior Director, Enrollment
- Phone
- (480) 853-0515
Specialties
- Community/Retail Pharmacy (3336C0003X)
- Durable Medical Equipment & Medical Supplies (332B00000X)
- Pharmacy (333600000X)
Browse Similar Providers
See more providers in the Pharmacy classification in Rochester, NY.
Open Pharmacy providers in Rochester, NY
Open the exact Community/Retail Pharmacy specialty directory in Rochester, NY
Medicare Part B Activity
Reported 40 Medicare fee-for-service service lines in 2024.
Peer comparison
Compared to Pharmacy providers in the Rochester, NY metro area.
This provider is in the 3rd percentile for Medicare service volume.
Lower volume than many peers.
Performs 86% fewer Medicare services than the peer median.
Higher than 4 of 120 peers.
- Activity Percentile
- 3.3%
- Rank by Services
- 115 of 120
- Total Services
- 40
- Est. Allowed Value
- $1,345.50
- Dataset Year
- 2024
- Drug Code Share
- 27.5%
Estimated allowed value reflects Medicare fee-for-service allowed amounts only. It does not include Medicare Advantage, commercial insurance, cash-pay services, or employment compensation.
Peers are grouped by the broader Pharmacy classification rather than the exact subspecialty label shown elsewhere on the page.
Percentile distribution
Each bar represents a 10-point percentile band of peers by total Medicare services for Pharmacy across the Rochester, NY metro area. Taller bars indicate higher service-volume bands. Highlighted bar marks this provider's percentile band.
Observed service range: 11 to 2,675 total Medicare services.
Top Clinical Services
- 90480: Admn sarscov2 vacc 1 dose
15 services | $155.26
- G0008: Administration of influenza virus vaccine
14 services | $290.22
Common Drug-Related Codes
- 90662: Influenza vaccine split virus, preservative free
11 services | $900.02
Organization Overview
Wal-Mart Stores East, LP operates as Walmart within Walmart Inc.’s U.S. retail network; Walmart’s own SEC exhibit lists it as a wholly owned subsidiary doing business as Walmart. In Rochester, the organization corresponds to Walmart Supercenter #3280, branded the Irondequoit Hudson Ave Supercenter, which serves the Rochester and West Irondequoit area. The store’s official pages list on-site health-related services including a Vision Center and pharmacy services, alongside the broader supercenter retail operation.
Full Record
- NPI
- 1225055395
- Entity Type
- Organization
- Organization Name
- Wal-Mart Stores East LP
- Provider Other Organization Name Type Code
- 6
- Mailing Street Address
- 702 Sw 8Th St
- Mailing City
- Bentonville
- Mailing State
- AR
- Mailing ZIP Code
- 72716-0445
- Mailing Country
- US
- Practice Street Address
- 1490 Hudson Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621-1701
- Practice Country
- US
- Practice Phone
- (585) 266-1640
- Enumeration Date
- July 16, 2006
- Last Updated
- June 18, 2025
- Authorized Official Last Name
- Canonic
- Authorized Official First Name
- Kimberly
- Authorized Official Title
- Senior Director, Enrollment
- Authorized Official Phone
- (480) 853-0515
- Organization Subpart
- No
- Certification Date
- June 18, 2025
- Taxonomies
- Community/Retail Pharmacy (3336C0003X), Durable Medical Equipment & Medical Supplies (332B00000X), Pharmacy (333600000X)
- Other Identifiers
- 2064164 (Pk), 2335431 (NY)