WAL-MART STORES EAST LP
NPI: 1073530143
· PLYMOUTH, WI 53073
· Durable Medical Equipment & Medical Supplies
· NPI assigned 07/16/2006
Billing Flags
· Automated signals — not evidence of fraud
Entity Proliferation
Authorized official CANONIC, KIMBERLY controls 20+ related entities in our dataset. Read more
$394.98
Total Medicaid Paid
Provider Details
| Authorized Official | CANONIC, KIMBERLY (SENIOR DIRECTOR, ENROLLMENT) |
| NPI Enumeration Date | 07/16/2006 |
Related Entities
Other providers sharing the same authorized official: CANONIC, KIMBERLY
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2022 |
16 |
$394.98 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| 90686 |
|
16 |
14 |
$394.98 |