Wal-Mart Stores East LP
Pharmacy, Community/Retail Pharmacy in Sumter, SC. Organization (NPI-2).
NPI number1730558024
StatusActive
Last updated in NPPESJun 12, 2025
Details
- NPI
- 1730558024
- Entity type
- Organization (NPI-2)
- Legal business name
- Wal-Mart Stores East LP
- Organization subpart
- No
- Enumeration date
- Sep 17, 2015
- Certification date
- Jun 12, 2025
- Last updated
- Jun 12, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 16204 | SC | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – |
Other names
- Walmart Pharmacy 10-5383 (Doing Business As)
Practice location
615 Bultman DrSumter, SC 29150-2514
Phone 803-305-6194 · Fax 803-305-6197
Mailing address
702 Sw 8th StMailstop 0445
Bentonville, AR 72716-0445
Phone 479-258-6180 · Fax 479-277-4331
Authorized official
Kimberly Canonic
Senior Director, Enrollment
4808530515
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