NPI 1083779409
Wal-Mart Stores East LP
Practice location
- Address
- 51 Silver Spring St, Providence, RI 02904-2557
- Phone
- (401) 272-5340
- Mailing address
- 702 SW 8th St, Bentonville, AR 72716-0445
Authorised official
- Name
- Kimberly Canonic
- Title
- Senior Director, Enrollment
- Phone
- (480) 853-0515
Registered specialties (3)
Community/Retail Pharmacy
Primary
Durable Medical Equipment & Medical Supplies
Specialty Pharmacy
Registry record
- NPI
- 1083779409
- Entity type
- Organization
- NPI issued
- 26 Dec 2006
- Record last updated
- 19 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.