Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-0416
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
140 JOE B JACKSON PKWY, MURFREESBORO, TN 37127-7228
(615) 907-8999
(615) 907-8998
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
00005487
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2150359
PK
—
Enumeration date
02/12/2015
Last updated
06/02/2025
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