Organization
WAL-MART STORES EAST LP
Active
Other names
WALMART PHARMACY 10-1124
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
1201 HIGHWAY 31 NW, HARTSELLE, AL 35640-4420
(256) 773-1799
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
110381
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100003339
—
AL
01
—
1993132
PK
—
Enumeration date
07/16/2006
Last updated
06/05/2025
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