NPI 1013934413

Wal-Mart Stores East LP

Organisation Specialty Pharmacy Orlando, FL

Practice location

Address: 2354 Commerce Park Dr STE 100, Orlando, FL 32819-8601
Phone: (877) 453-4566
Fax: (866) 537-0877
Mailing address: 702 SW 8th St, Bentonville, AR 72716-0445

Authorised official

Name: Kimberly Canonic
Title: Senior Director, Enrollment
Phone: (479) 371-1168

Registered specialties (15)

Specialty Pharmacy Primary

Suppliers Taxonomy 3336S0011X Licence OS01543 (AR)

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Registry record

NPI: 1013934413
Entity type: Organization
NPI issued: 16 Jul 2006
Record last updated: 12 Jun 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.