Organization · Type 2 NPI

Wal-Mart Stores East LP

Community/Retail Pharmacy · Memphis, TN

NPI number 1174540363 Active

Practice location

3950 Austin Peay Hwy
Memphis, TN 38128-2516

Call (901) 377-2422 Map

Fax (901) 377-2065

Mailing address

702 SW 8th St, Mail Stop 0445
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	2283 (TN)
Specialty Pharmacy	3336S0011X	None listed

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

7 other providers at this address

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NPI record

NPI: 1174540363
Entity type: Organization (Type 2)
Issued: Jul 16, 2006
Last updated: Jul 11, 2025
Status: Active

Other names

<unavail>
Wal-Mart Pharmacy 10-1561 · doing business as
Wal-Mart Pharmacy 10-1561 · doing business as

Authorized official

Kimberly Canonic
Senior Director, Enrollment
(480) 277-6348

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1174540363

Wal-Mart Stores East LP's National Provider Identifier is 1174540363, issued on Jul 16, 2006. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Memphis, TN. The record was last updated on Jul 11, 2025.