Wal-Mart Stores East LP
Pharmacy, Community/Retail Pharmacy in Tamarac, FL. Organization (NPI-2).
NPI number1154725331
StatusActive
Last updated in NPPESJun 6, 2025
Details
- NPI
- 1154725331
- Entity type
- Organization (NPI-2)
- Legal business name
- Wal-Mart Stores East LP
- Organization subpart
- No
- Enumeration date
- Oct 16, 2014
- Certification date
- Jun 6, 2025
- Last updated
- Jun 6, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | PH28792 | FL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – |
Other names
- Walmart Pharmacy 10-2930 (Doing Business As)
Practice location
6931 Nw 88th AveTamarac, FL 33321-3221
Phone 954-247-6319
Mailing address
702 Sw 8th StMailstop 0445
Bentonville, AR 72716-0445
Phone 479-277-2500 · Fax 479-277-4331
Authorized official
Kimberly Canonic
Senior Director, Enrollment
4802776348
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