Wal-Mart Stores East LP
Pharmacy, Community/Retail Pharmacy in Swainsboro, GA. Organization (NPI-2).
NPI number1669499075
StatusActive
Last updated in NPPESJun 4, 2025
Details
- NPI
- 1669499075
- Entity type
- Organization (NPI-2)
- Legal business name
- Wal-Mart Stores East LP
- Organization subpart
- No
- Enumeration date
- Jul 16, 2006
- Certification date
- Jun 4, 2025
- Last updated
- Jun 4, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · DME SUPPLIER - PHARMACY
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | PHRE006758 | GA | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 333600000X | Pharmacy | – | – |
Other names
- Walmart Pharmacy 10-1024 (Doing Business As)
Practice location
414 S Main StSwainsboro, GA 30401-3676
Phone 478-237-3524
Mailing address
702 Sw 8th StBentonville, AR 72716-0445
Authorized official
Kimberly Canonic
Senior Director, Enrollment
4802776348
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All 8 Community/Retail Pharmacy providers in Swainsboro · All 304 providers in Swainsboro
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