Wal-Mart Stores East LP
Pharmacy, Community/Retail Pharmacy in Clarksdale, MS. Organization (NPI-2).
NPI number1396762829
StatusActive
Last updated in NPPESJun 3, 2025
Details
- NPI
- 1396762829
- Entity type
- Organization (NPI-2)
- Legal business name
- Wal-Mart Stores East LP
- Organization subpart
- No
- Enumeration date
- Jul 17, 2006
- Certification date
- Jun 3, 2025
- Last updated
- Jun 3, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 02050 | MS | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 333600000X | Pharmacy | – | – |
Other names
- Walmart Pharmacy 10-0707 (Doing Business As)
Practice location
1000 S State StClarksdale, MS 38614-4704
Phone 662-624-2523
Mailing address
702 Sw 8th StBentonville, AR 72716-0445
Authorized official
Kimberly Canonic
Senior Director, Enrollment
4802776348
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All 10 Community/Retail Pharmacy providers in Clarksdale · All 467 providers in Clarksdale
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