Organization
WAL-MART STORES EAST, LP
Active
Other names
Walmart Pharmacy 10-2229
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (DIRECTOR OF HEALTH CARE CONTRACTING)
(480) 277-6348
Entity
Organization
Contact information
Practice address
5551 N US HWY 41, APOLLO BEACH, FL 33572-0000
(813) 922-7906
(813) 922-7907
Mailing address
1 CUSTOMER DR, MS 0445, BENTONVILLE, AR 72716
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Enumeration date
10/24/2025
Last updated
10/24/2025
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