Wal-Mart Stores East LP
NPI #1174540595 in Jackson, Mississippi
Provider Information
- NPI Number
- 1174540595
- Entity Type
- Organization
- Organization Name
- Wal-Mart Stores East LP
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jul 16, 2006
- Last Updated
- Jun 3, 2025
Practice Location
- Address
- 2711 GREENWAY DR
- City
- Jackson
- State
- Mississippi
- ZIP Code
- 39204-3304
- Phone
- (601) 922-2876
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 Pharmacy — Community/Retail Pharmacy |
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