Wal-Mart Stores East LP

NPI #1194926642 in Rockmart, Georgia

Provider Information

NPI Number
1194926642
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
May 31, 2007
Last Updated
Jul 11, 2025

Practice Location

Address
1801 NATHAN DEAN BYP
State
Georgia
ZIP Code
30153-2019
Phone
(678) 757-9756

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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