Organization
WAL-MART STORES EAST LP
Active
Other names
WALMART PHARMACY 10-0392
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
1349 E EAGLE RD, WEATHERFORD, OK 73096-9208
(580) 772-2712
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
285460
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100793210B
—
OK
01
—
2076066
PK
—
Enumeration date
07/16/2006
Last updated
05/30/2025
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