Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-7174
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
5700 HOPKINS RD, NORTH CHESTERFIELD, VA 23234-6631
(804) 253-0759
(804) 253-9788
Mailing address
702 SW 8TH ST, 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
0201004628
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619367174
—
VA
01
—
2150121
PK
—
Enumeration date
02/04/2015
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