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Organization
WAL-MART STORES EAST LP
Active
Organization
WAL-MART STORES EAST LP
Active
Other names
WalMart Pharmacy 10-4188
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
1410 FLORENCE BLVD, FLORENCE, AL 35630-2700
(256) 712-6198
(256) 767-4062
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-2500
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
114120
AL
Other
Enumeration date
03/25/2013
Last updated
06/06/2025
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