Wal-Mart Stores East LP
Pharmacy in Starkville, MS. Organization (NPI-2).
NPI number1982113049
StatusActive
Last updated in NPPESJun 10, 2025
Details
- NPI
- 1982113049
- Entity type
- Organization (NPI-2)
- Legal business name
- Wal-Mart Stores East LP
- Organization subpart
- No
- Enumeration date
- Sep 21, 2017
- Certification date
- Jun 10, 2025
- Last updated
- Jun 10, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | 16551 | MS | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – |
Other names
- Walmart Pharmacy 10-5459 (Doing Business As)
Practice location
105 Market StStarkville, MS 39759-4270
Phone 662-270-6296 · Fax 662-270-6297
Mailing address
702 Sw 8th StBentonville, AR 72716-0445
Phone 479-277-1242 · Fax 479-277-4331
Authorized official
Kimberly Canonic
Senior Director, Enrollment
4802776348
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