Wal-Mart Stores East LP

NPI #1194197533 in Radcliff, Kentucky

Provider Information

NPI Number
1194197533
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy
Enumeration Date
Oct 26, 2015
Last Updated
Jun 10, 2025

Practice Location

Address
102 GATEWAY CROSSING BLVD
ZIP Code
40160-9204
Phone
(270) 351-3625

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
Pharmacy

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