Organization · Type 2 NPI

Wal-Mart Stores East LP

Community/Retail Pharmacy · Jacksonville, FL

NPI number 1609818673 Active

Practice location

4250 Philips Hwy
Jacksonville, FL 32207-6730

Call (904) 737-7001 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	PH22042 (FL)
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 …

4 other providers at this address

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NPI record

NPI: 1609818673
Entity type: Organization (Type 2)
Issued: Jun 12, 2006
Last updated: Jun 19, 2025
Status: Active

Other names

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Walmart Pharmacy 10-3309 · doing business as
Walmart Pharmacy 10-3309 · 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 1609818673

Wal-Mart Stores East LP's National Provider Identifier is 1609818673, issued on Jun 12, 2006. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Jacksonville, FL. The record was last updated on Jun 19, 2025.