Wal-Mart Stores East LP
NPI #1386663391 in Broken Arrow, Oklahoma
Provider Information
- NPI Number
- 1386663391
- Entity Type
- Organization
- Organization Name
- Wal-Mart Stores East LP
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jul 19, 2006
- Last Updated
- Jul 1, 2025
Practice Location
- Address
- 1770 S ELM PL
- City
- Broken Arrow
- State
- Oklahoma
- ZIP Code
- 74012-6453
- Phone
- (918) 258-6185
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 Pharmacy — Community/Retail Pharmacy |
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| Tcaacp LLC | |
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