Wal-Mart Stores East LP

NPI #1619391372 in Blue Ridge, Georgia

Provider Information

NPI Number
1619391372
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Feb 14, 2014
Last Updated
Jun 6, 2025

Practice Location

Address
97 COMMERCE DR
State
Georgia
ZIP Code
30513-3677
Phone
(706) 632-9508

Authorized Official

Name
KIMBERLY CANONIC
Title
SENIOR DIRECTOR, ENROLLMENT
Phone
(480) 277-6348

Specialties & Taxonomy Codes

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

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