Organization
WAL-MART STORES EAST , LP
Active
Other names
Walmart Pharmacy 10-3637
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
1001 E MAIN ST, YUKON, OK 73099-2137
(405) 577-0051
(405) 577-0053
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
26-6921
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100242350 C
—
OK
01
—
2149141
PK
—
Enumeration date
10/07/2014
Last updated
07/02/2025
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