Organization
WAL-MART STORES EAST LP
Active
Other names
WalMart Pharmacy 10-5476
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
820 COOPER ST, WOODBURY, NJ 08096-2598
(856) 686-1382
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00695500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0215856
—
NJ
01
—
2120419
PK
—
Enumeration date
05/13/2009
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