Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-1841
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
1521 SAMS CIR, CHESAPEAKE, VA 23320-4694
(757) 436-6855
(757) 436-6356
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 371-8711
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
04/10/2023
Last updated
06/16/2025
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