Organization
WAL-MART STORES EAST LP
Active
Other names
WAL-MART PHARMACY 10-3342
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
1815 E OHIO PIKE, AMELIA, OH 45102-2380
(513) 797-1250
(513) 797-1254
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
021561850
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021561850
—
OH
01
—
2080343
PK
—
05
—
2645267
—
OH
Enumeration date
07/16/2006
Last updated
06/19/2025
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