Wal-Mart Stores East LP
Pharmacy, Community/Retail Pharmacy in Lecanto, FL. Organization (NPI-2).
NPI number1407190036
StatusActive
Last updated in NPPESJun 16, 2025
Details
- NPI
- 1407190036
- Entity type
- Organization (NPI-2)
- Legal business name
- Wal-Mart Stores East LP
- Organization subpart
- No
- Enumeration date
- Nov 20, 2012
- Certification date
- Jun 16, 2025
- Last updated
- Jun 16, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | PH26604 | FL | Yes |
Other names
- Walmart Pharmacy 10-5772 (Doing Business As)
Practice location
1936 N Lecanto HwyLecanto, FL 34461-9680
Phone 352-228-6003 · Fax 352-228-6004
Mailing address
702 Sw 8th StBentonville, AR 72716-0445
Phone 479-204-0709 · Fax 479-277-4331
Authorized official
Kimberly Canonic
Senior Director, Enrollment
4808530515
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