Wal-Mart Stores East LP

NPI #1285651414 in Pewaukee, Wisconsin

Provider Information

NPI Number
1285651414
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jul 16, 2006
Last Updated
Jun 19, 2025

Practice Location

Address
411 PEWAUKEE RD
ZIP Code
53072-5886
Phone
(262) 695-2878

Authorized Official

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

Specialties & Taxonomy Codes

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

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