Organization · Type 2 NPI

Wal-Mart Stores East, LP

Community/Retail Pharmacy · Blue Springs, MS

NPI number 1669037958 Active

Practice location

1200 Magnolia Way
Blue Springs, MS 38828-6000

Call (479) 277-2500 Map

Mailing address

1 Customer Dr
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Community/Retail Pharmacy Primary	3336C0003X	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 …

6 other providers at this address

NPI record

NPI: 1669037958
Entity type: Organization (Type 2)
Issued: May 2, 2019
Last updated: Apr 13, 2026
Status: Active

Other names

<unavail>
Walmart Pharmacy 10-3913 · doing business as
Walmart Pharmacy 10-3913 · 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 1669037958

Wal-Mart Stores East, LP's National Provider Identifier is 1669037958, issued on May 2, 2019. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Blue Springs, MS. The record was last updated on Apr 13, 2026.