Wal-Mart Stores East LP

NPI #1780778845 in Malone, New York

Provider Information

NPI Number
1780778845
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
3222 STATE ROUTE 11
City
Malone
ZIP Code
12953-4709
Phone
(518) 483-8724

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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