{"npi":"1306224696","type":"NPI-2","status":"active","name":{"display":"Wal-Mart Stores East Lp","other":[],"organization_name":"WAL-MART STORES EAST LP","authorised_official":"Kimberly Canonic"},"specialty":{"primary_taxonomy":"3336C0003X","primary_taxonomy_description":"Community/Retail Pharmacy","slug":"community-retail-pharmacy","schema_org_specialty":null,"all":[{"code":"332B00000X","description":"Durable Medical Equipment & Medical Supplies","primary":false,"state":null,"license":null},{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":true,"state":"IN","license":"60006497A"}]},"addresses":[{"purpose":"LOCATION","street_1":"4837 KENTUCKY AVE","city":"INDIANAPOLIS","state":"IN","postal_code":"462213533","country_code":"US","phone":"3178304259","fax":"3178304103"},{"purpose":"MAILING","street_1":"702 SW 8TH ST","city":"BENTONVILLE","state":"AR","postal_code":"727166209","country_code":"US","street_2":"MAILSTOP 0445","phone":"4798048550","fax":"4792774331"}],"license":{"state":"IN","number":"60006497A"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"201325620 A","state":"IN","issuer":null},{"type_code":"01","label":"Other","value":"2152940","state":null,"issuer":"PK"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20151119000547","type_code":"30-A5","type_desc":"DME SUPPLIER - PHARMACY","state":"IN","pac_id":"6204749997"}]},"enumeration_date":"2015-05-07","last_updated":"2025-06-09","_meta":{"source":"NPPES","snapshot_date":"2025-06-09","doc_url":"https://findmynpi.com/api"}}