Wal-Mart Stores East LP

NPI #1033136411 in Port Orange, Florida

Provider Information

NPI Number
1033136411
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jul 16, 2006
Last Updated
Jun 2, 2025

Practice Location

Address
1590 DUNLAWTON AVE
State
Florida
ZIP Code
32127-4752
Phone
(386) 761-0191

Authorized Official

Name
KIMBERLY CANONIC
Title
SENIOR DIRECTOR, ENROLLMENT
Phone
(480) 277-6348

Specialties & Taxonomy Codes

Specialty
Durable Medical Equipment & Medical Supplies
Pharmacy
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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