Walmart Stores East LP

NPI #1619424298 in Derby, Vermont

Provider Information

NPI Number
1619424298
Entity Type
Organization
Organization Name
Walmart Stores East LP
Primary Specialty
Pharmacy
Enumeration Date
Sep 1, 2016
Last Updated
Jun 5, 2025

Practice Location

Address
115 SEYMOUR DRIVE
City
Derby
State
Vermont
ZIP Code
05829-0000
Phone
(802) 624-8011

Authorized Official

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

Specialties & Taxonomy Codes

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

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