Organization
WAL-MART STORES EAST LP
Active
Other names
WALMART PHARMACY 10-1974
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
17 LUDLOW RD, HOULTON, ME 04730-3524
(207) 532-2213
(479) 277-4331
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
PH50001148
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187470001
—
ME
01
—
2036830
PK
—
05
—
999010036
—
ME
Enumeration date
07/16/2006
Last updated
06/09/2025
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