Organization · NPI-2
Wal-Mart Stores East LP
Pharmacy, Community/Retail Pharmacy · Willow Grove, PA
NPI number1962675512
StatusActive
Last updated in NPPESJul 1, 2025
Details
- NPI
- 1962675512
- Entity type
- Organization (NPI-2)
- Legal business name
- Wal-Mart Stores East LP
- Organization subpart
- No
- Enumeration date
- Apr 3, 2008
- Certification date
- Jul 1, 2025
- Last updated
- Jul 1, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | PP481828 | PA | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – |
Other names
- Wal-Mart Pharmacy 10-3564 (Doing Business As)
Practice location
2101 Blair Mill RdWillow Grove, PA 19090-1751
Phone 215-672-1300
Mailing address
702 Sw 8th StBentonville, AR 72716-0445
Phone 479-277-1242
Authorized official
Kimberly Canonic
Senior Director, Enrollment
4802776348
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