Wal-Mart Stores East LP

NPI #1114035508 in Lake Park, Florida

Provider Information

NPI Number
1114035508
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Aug 27, 2006
Last Updated
Jun 19, 2025

Practice Location

Address
101 N CONGRESS AVE
State
Florida
ZIP Code
33403-3804
Phone
(561) 842-8966

Authorized Official

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

Specialties & Taxonomy Codes

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

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