Wal-Mart Stores East , LP
NPI #1023410297 in Broken Arrow, Oklahoma
Provider Information
- NPI Number
- 1023410297
- Entity Type
- Organization
- Organization Name
- Wal-Mart Stores East , LP
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Sep 19, 2014
- Last Updated
- Jun 9, 2025
Practice Location
- Address
- 4851 W. HOUSTON ST
- City
- Broken Arrow
- State
- Oklahoma
- ZIP Code
- 74012
- Phone
- (918) 505-6094
Authorized Official
- Name
- KIMBERLY CANONIC
- Title
- SENIOR DIRECTOR, ENROLLMENT
- Phone
- (480) 277-6348
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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