# WAL-MART STORES EAST, LP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** WALMART PHARMACY 10-1176
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346268042
- **Authorized official:** KIMBERLY CANONIC (DIRECTOR)
- **Authorized official phone:** (480) 853-0515

## Contact information

- **Practice address:** 2600 STATE HWY 138, WALMART PHARMACY 10-1176, STROUGHTON, WI 53589-3701
- **Practice address phone:** (608) 873-9262
- **Practice address fax:** (608) 873-9780
- **Mailing address:** 1 CUSTOMER DR, MS 0445, BENTONVILLE, AR 72716-0445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 9444-42 | WI | Yes |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 04/27/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2114776 | PK | — |
| 05 | — | 33155500 | — | WI |