NPI 1053771386

Wal-Mart Stores East LP

Organisation Community/Retail Pharmacy Tupelo, MS

Practice location

Address: 316 S Gloster St, Tupelo, MS 38801-4748
Phone: (662) 350-6920
Fax: (662) 350-6919
Mailing address: 702 SW 8th St Ms 0445, Bentonville, AR 72716-0445

Authorised official

Name: Kimberly Canonic
Title: Senior Director, Enrollment
Phone: (480) 853-0515

Registered specialties (3)

Community/Retail Pharmacy Primary

Suppliers Taxonomy 3336C0003X Licence 14710/1.2 (MS)

Other Pharmacy providers in Mississippi →

Durable Medical Equipment & Medical Supplies

Suppliers Taxonomy 332B00000X

Other Durable Medical Equipment & Medical Supplies providers in Mississippi →

Pharmacy

Suppliers Taxonomy 333600000X

Registry record

NPI: 1053771386
Entity type: Organization
NPI issued: 29 Feb 2016
Record last updated: 18 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.