Wal-Mart Stores East LP

NPI #1215119946 in Gainesville, Florida

Provider Information

NPI Number
1215119946
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Dec 5, 2007
Last Updated
Jul 8, 2025

Practice Location

Address
1800 NE 12TH AVE
State
Florida
ZIP Code
32641-4610
Phone
(352) 372-3191

Authorized Official

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

Specialties & Taxonomy Codes

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

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