Wal-Mart Stores East LP

NPI #1184027211 in Poplar Bluff, Missouri

Provider Information

NPI Number
1184027211
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Oct 3, 2014
Last Updated
Jun 9, 2025

Practice Location

Address
3001 OAK GROVE RD
ZIP Code
63901-8942
Phone
(573) 772-7169

Authorized Official

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

Specialties & Taxonomy Codes

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

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