Organization · Type 2 NPI

Wal-Mart Stores East LP

Community/Retail Pharmacy · Greendale, WI

NPI number 1902142672 Active

Practice location

5301 S 76th St
Greendale, WI 53129-1128

Call (414) 978-9016 Map

Mailing address

702 SW 8th St
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Community/Retail Pharmacy Primary	3336C0003X	9182-42 (WI)

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: 1902142672
Entity type: Organization (Type 2)
Issued: Dec 27, 2012
Last updated: Jun 5, 2025
Status: Active

Other names

<unavail>
Walmart Pharmacy 10-5668 · doing business as
Walmart Pharmacy 10-5668 · doing business as

Authorized official

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

Verify this record

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 1902142672

Wal-Mart Stores East LP's National Provider Identifier is 1902142672, issued on Dec 27, 2012. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Greendale, WI. The record was last updated on Jun 5, 2025.