Organization · Type 2 NPI

Wal-Mart Stores East LP

Pharmacy · Jacksonville, FL

NPI number 1356842512 Active

Practice location

9550 Baymeadows Rd
Jacksonville, FL 32256-0710

Call (904) 513-5696 Map

Fax (904) 831-5227

Mailing address

702 SW 8th St
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy Primary	333600000X	None listed
Community/Retail Pharmacy	3336C0003X	None listed

Pharmacy: A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is lo…

5 other providers at this address

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NPI record

NPI: 1356842512
Entity type: Organization (Type 2)
Issued: Feb 23, 2018
Last updated: Jun 10, 2025
Status: Active

Other names

<unavail>
Walmart Pharmacy 10-4561 · doing business as
Walmart Pharmacy 10-4561 · doing business as

Authorized official

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

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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 1356842512

Wal-Mart Stores East LP's National Provider Identifier is 1356842512, issued on Feb 23, 2018. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Jacksonville, FL. The record was last updated on Jun 10, 2025.