Wal-Mart Stores East LP

NPI #1780601039 in Fenton, Missouri

Provider Information

NPI Number
1780601039
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jul 16, 2006
Last Updated
Jun 3, 2025

Practice Location

Address
653 GRAVOIS BLUFFS BLVD
City
Fenton
ZIP Code
63026-7716
Phone
(636) 349-3007

Authorized Official

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

Specialties & Taxonomy Codes

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

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