Wal-Mart Stores East LP

NPI #1265459317 in Portage, Wisconsin

Provider Information

NPI Number
1265459317
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jul 16, 2006
Last Updated
Jun 16, 2025

Practice Location

Address
2950 NEW PINERY RD
ZIP Code
53901-9225
Phone
(608) 742-1670

Authorized Official

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

Specialties & Taxonomy Codes

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

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