Wal-Mart Stores East , LP

NPI #1952710493 in Diberville, Mississippi

Provider Information

NPI Number
1952710493
Entity Type
Organization
Organization Name
Wal-Mart Stores East , LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Aug 8, 2014
Last Updated
Jun 9, 2025

Practice Location

Address
10290 DIBERVILLE BLVD
ZIP Code
39540-2536
Phone
(228) 271-6753

Authorized Official

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

Specialties & Taxonomy Codes

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

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