Wal-Mart Stores East, LP

NPI #1093486078 in Yaphank, New York

Provider Information

NPI Number
1093486078
Entity Type
Organization
Organization Name
Wal-Mart Stores East, LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Sep 21, 2021
Last Updated
Jun 11, 2025

Practice Location

Address
901 BOULEVARD E
ZIP Code
11980-7511
Phone
(631) 729-4040

Authorized Official

Name
KIMBERLY CANONIC
Title
SENIOR DIRECTOR, ENROLLMENT
Phone
(480) 853-0515

Specialties & Taxonomy Codes

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

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