Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-4160
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
1101 S GOLDWYN AVE, ORLANDO, FL 32805-4307
(407) 563-9147
(407) 822-5287
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-2500
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH26891
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008929500
—
FL
01
—
2140398
PK
—
Enumeration date
05/13/2013
Last updated
06/06/2025
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