Organization
WAL-MART STORES EAST LP
Active
Other names
WAL-MART PHARMACY 10-3840
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
1161 TRENTON AVE, FINDLAY, OH 45840-1919
(419) 425-5992
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
021593700
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2080409
PK
—
05
—
2684028
—
OH
05
—
2690173
—
OH
Enumeration date
07/18/2006
Last updated
07/08/2025
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