Wal-Mart Stores East LP

NPI #1104297753 in Horn Lake, Mississippi

Provider Information

NPI Number
1104297753
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Oct 8, 2015
Last Updated
Jun 9, 2025

Practice Location

Address
4150 GOODMAN RD
ZIP Code
38637-0300
Phone
(662) 253-6181

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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