Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-4357
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
6670 MOBILE HWY, PENSACOLA, FL 32526-1265
(850) 483-6175
Mailing address
702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-6209
(479) 277-2500
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH28244
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012233900
—
FL
05
—
012233901 DME
—
FL
01
—
2145455
PK
—
Enumeration date
03/29/2014
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