Organization · Type 2 NPI

Wal-Mart Stores East, LP

Community/Retail Pharmacy · Port St. Lucie, FL

NPI number 1700335312 Active

Practice location

3045 SW Port St Lucie Blvd
Port St. Lucie, FL 34953-0000

Call (772) 301-6124 Map

Mailing address

702 SW 8th St, Mailstop 0445
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
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 …

3 other providers at this address

Other community/retail pharmacy providers in Port St. Lucie

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NPI record

NPI: 1700335312
Entity type: Organization (Type 2)
Issued: Sep 23, 2016
Last updated: Jun 12, 2025
Status: Active
Subpart: Yes of Wal-Mart Stores, Inc.

Other names

<unavail>
Walmart Pharmacy 10-5704 · 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 1700335312

Wal-Mart Stores East, LP's National Provider Identifier is 1700335312, issued on Sep 23, 2016. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Port St. Lucie, FL. The record was last updated on Jun 12, 2025.