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) 292-0990.
Source: public NPPES record, last updated July 11, 2025. This profile is informational and is not medical advice, a quality rating, or a provider recommendation.
Profile Overview
- NPI
- 1780601922
- Provider Type
- Organization
- Primary Specialty
- Community/Retail Pharmacy
- Enumeration Date
- July 16, 2006
- Last Updated
- July 11, 2025
Practice Location
- 1200 Marketplace Dr
- Rochester, NY 14623-6002
Phone: (585) 292-0990
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)
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Medicare Part B Activity
Reported 128 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 19th percentile for Medicare service volume.
Lower volume than many peers.
Performs 56% fewer Medicare services than the peer median.
Higher than 23 of 120 peers.
- Activity Percentile
- 19.2%
- Rank by Services
- 97 of 120
- Total Services
- 128
- Est. Allowed Value
- $10,128.40
- Dataset Year
- 2024
- Drug Code Share
- 47.7%
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
- G0008: Administration of influenza virus vaccine
28 services | $584.84
- 90480: Admn sarscov2 vacc 1 dose
25 services | $255.70
- G0009: Administration of pneumococcal vaccine
14 services | $229.54
Common Drug-Related Codes
- 90662: Influenza vaccine split virus, preservative free
25 services | $2,035.61
- 91322: Sarscov2 vac 50 mcg/0.5ml im
14 services | $2,187.04
- 90677: Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use
11 services | $3,203.69
Organization Overview
WAL-MART STORES EAST LP operates the Walmart Pharmacy at Walmart Supercenter #1619 in Rochester, New York. The location is part of Walmart’s Henrietta Marketplace Drive Supercenter and includes a pharmacy offering prescription refills, prescription transfers, vaccines, low-cost generic medications, and pharmacy delivery. Walmart’s store page also lists related on-site services at this Supercenter, including a Vision Center, COVID immunizations, flu shots and immunizations, and a fuel station.
Full Record
- NPI
- 1780601922
- 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
- 1200 Marketplace Dr
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14623-6002
- Practice Country
- US
- Practice Phone
- (585) 292-0990
- Enumeration Date
- July 16, 2006
- Last Updated
- July 11, 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
- July 11, 2025
- Taxonomies
- Community/Retail Pharmacy (3336C0003X), Durable Medical Equipment & Medical Supplies (332B00000X), Pharmacy (333600000X)
- Other Identifiers
- 1239289 (NY), 2066892 (Pk)