Organization
WAL-MART STORES EAST LP
Active
Other names
WALMART PHARMACY 10-5218
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
3501 34TH ST S, ST PETERSBURG, FL 33711-3820
(727) 906-4030
(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
PH21048
FL
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028317700
—
FL
01
—
2004033
PK
—
05
—
28317700
—
FL
Enumeration date
07/16/2006
Last updated
06/13/2025
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