Wal-Mart Stores East LP

NPI #1215948732 in Daytona Beach, Florida

Provider Information

NPI Number
1215948732
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Aug 10, 2006
Last Updated
Jul 8, 2025

Practice Location

Address
1905 N NOVA RD
State
Florida
ZIP Code
32117-1421
Phone
(386) 672-8955

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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