Wal-Mart Stores East LP

NPI #1700970860 in Stockbridge, Georgia

Provider Information

NPI Number
1700970860
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Oct 3, 2006
Last Updated
Jun 19, 2025

Practice Location

Address
1400 HUDSON BRIDGE RD
State
Georgia
ZIP Code
30281-5018
Phone
(770) 474-0454

Authorized Official

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

Specialties & Taxonomy Codes

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

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