Organization
WAL-MART STORES EAST LP
Active
Other names
WAL-MART PHARMACY 10-1844
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
950 ROUTE 37 W, TOMS RIVER, NJ 08755-5018
(732) 349-6464
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
28RS00475800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2052456
PK
—
05
—
5461308
—
NJ
Enumeration date
07/16/2006
Last updated
06/16/2025
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