Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-5829
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
211 NOR DAN DR STE 1010, DANVILLE, VA 24540-1658
(434) 441-4252
(434) 441-4251
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
0201004726
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184072381
—
VA
01
—
2160712
PK
—
Enumeration date
05/27/2016
Last updated
06/18/2025
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