Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-7188
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
251 ANDOVER PL, DARLINGTON, SC 29532-1500
(843) 395-8467
(843) 395-8469
Mailing address
702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
16540
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159086
PK
—
05
—
716540
—
SC
Enumeration date
03/28/2016
Last updated
06/09/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us