Wal-Mart Stores East LP

NPI #1760409973 in West Melbourne, Florida

Provider Information

NPI Number
1760409973
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jul 16, 2006
Last Updated
Jun 4, 2025

Practice Location

Address
845 PALM BAY RD NE
State
Florida
ZIP Code
32904-8400
Phone
(321) 984-1612

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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