Wal-Mart Stores East LP

NPI #1902142672 in Greendale, Wisconsin

Provider Information

NPI Number
1902142672
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Dec 27, 2012
Last Updated
Jun 5, 2025

Practice Location

Address
5301 S 76TH ST
ZIP Code
53129-1128
Phone
(414) 978-9016

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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