NPI 1023410297
Wal-Mart Stores East , LP
Practice location
- Address
- 4851 W. Houston St, Broken Arrow, OK 74012
- Phone
- (918) 505-6094
- Fax
- (918) 505-6095
- Mailing address
- 702 SW 8th St, Bentonville, AR 72716-0445
Authorised official
- Name
- Kimberly Canonic
- Title
- Senior Director, Enrollment
- Phone
- (480) 277-6348
Registered specialties (2)
Community/Retail Pharmacy
Primary
Durable Medical Equipment & Medical Supplies
Registry record
- NPI
- 1023410297
- Entity type
- Organization
- NPI issued
- 19 Sep 2014
- Record last updated
- 9 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.