Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-5347
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
19975 S TAMIAMI TRL, ESTERO, FL 33928-2268
(239) 590-9506
(239) 590-9504
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
PH29251
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015415100
—
FL
05
—
015415101 DME
—
FL
01
—
2152269
PK
—
Enumeration date
05/29/2015
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