Wal-Mart Stores East LP

NPI #1972522951 in Goshen, Indiana

Provider Information

NPI Number
1972522951
Entity Type
Organization
Organization Name
Wal-Mart Stores East LP
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Jul 19, 2006
Last Updated
Jul 11, 2025

Practice Location

Address
4024 ELKHART RD STE 2
City
Goshen
State
Indiana
ZIP Code
46526-5801
Phone
(574) 875-6921

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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