Organization · Type 2 NPI

Wal-Mart Stores East LP

Community/Retail Pharmacy · Daytona Beach, FL

NPI number 1215948732 Active

Practice location

1905 N Nova Rd
Daytona Beach, FL 32117-1421

Call (386) 672-8955 Map

Fax (479) 277-4331

Mailing address

702 SW 8th St
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	PH22245 (FL)

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 …

3 other providers at this address

Other community/retail pharmacy providers in Daytona Beach

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NPI record

NPI: 1215948732
Entity type: Organization (Type 2)
Issued: Aug 10, 2006
Last updated: Jul 8, 2025
Status: Active

Other names

<unavail>
Walmart Pharmacy 10-3862 · doing business as
Walmart Pharmacy 10-3862 · doing business as

Authorized official

Kimberly Canonic
Senior Director, Enrollment
(480) 853-0515

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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 1215948732

Wal-Mart Stores East LP's National Provider Identifier is 1215948732, issued on Aug 10, 2006. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Daytona Beach, FL. The record was last updated on Jul 8, 2025.