Organization
WAL-MART STORES EAST LP
Active
Other names
WALMART PHARMACY 10-2331
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
155 PARKWAY N, WATERFORD, CT 06385-1208
(860) 447-3747
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
PCY.0001581
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004162848
—
CT
01
—
2001599
PK
—
05
—
940004162848
—
CT
Enumeration date
07/17/2006
Last updated
06/18/2025
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