Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-3202
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
4900 S SOONER RD, OKLAHOMA CITY, OK 73135-5428
(405) 458-6260
(405) 458-6257
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-2500
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1-6934
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100231610 S
—
OK
01
—
2149224
PK
—
Enumeration date
12/09/2014
Last updated
06/10/2025
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