Organization
WAL-MART STORES EAST , LP
Active
Other names
Walmart Pharmacy 10-7308
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
2551 CLASSEN BLVD, NORMAN, OK 73071-4381
(405) 515-7423
(405) 515-7420
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-2500
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
7-6951
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100231610W
—
OK
01
—
2149237
PK
—
Enumeration date
12/04/2014
Last updated
06/09/2025
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