WAL-MART STORES EAST LP NPI 1013934413

NPI Information

  • NPI: 1013934413
  • Provider Name: WAL-MART STORES EAST LP
  • Classification: Pharmacy - 3336S0011X
  • Specialization: Specialty Pharmacy
  • Entity Type: Organization
  • :
  • Address: 2354 COMMERCE PARK DR STE 100
    ORLANDO, FL
    ZIP 32819
  • Phone: (877) 453-4566

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NPI Details

WAL-MART STORES EAST LP is a specialty pharmacy pharmacy in Orlando, FL. The provider is a pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. WAL-MART STORES EAST LP NPI is 1013934413. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

2354 COMMERCE PARK DR STE 100
ORLANDO, FL
ZIP 32819-601
Phone: (877) 453-4566
Fax: (866) 537-0877

The provider's authorized official is Kimberly Canonic .
The authorized official title is Senior Director, Enrollment and has the following contact phone number (479) 371-1168.

The enumeration date for this NPI number is 7/16/2006 and was last updated on 6/12/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336S0011XPharmacySpecialty Pharmacy965NORTH DAKOTANo
23336S0011XPharmacySpecialty PharmacyPHA-MOP-LIC-12447MONTANANo
33336S0011XPharmacySpecialty Pharmacy262265MINNESOTANo
43336S0011XPharmacySpecialty PharmacyFL873KENTUCKYNo
53336S0011XPharmacySpecialty Pharmacy054.015021ILLINOISNo
63336S0011XPharmacySpecialty Pharmacy64000468AINDIANANo
73336S0011XPharmacySpecialty PharmacyPHY.005063-OSLOUISIANANo
83336S0011XPharmacySpecialty Pharmacy22601TEXASNo
93336S0011XPharmacySpecialty Pharmacy3872TENNESSEENo
103336S0011XPharmacySpecialty Pharmacy5301007714MICHIGANNo
113336S0011XPharmacySpecialty Pharmacy2003010214MISSOURINo
123336S0011XPharmacySpecialty Pharmacy99-6096OKLAHOMANo
133336S0011XPharmacySpecialty PharmacyPH18943FLORIDANo
143336S0011XPharmacySpecialty Pharmacy021368750-03OHIONo
153336S0011XPharmacySpecialty PharmacyOS01543ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1006340MEDICAIDFLORIDA
2025831800MEDICAIDFLORIDA
30311413MEDICAIDNEW JERSEY
41013934413MEDICAIDALABAMA
525831800MEDICAIDFLORIDA
680658873MEDICAIDCOLORADO
72015188OTHERPK
83810010863MEDICAIDFLORIDA
91013934413MEDICAIDFLORIDA
101007455310380MEDICAIDPENNSYLVANIA
11100445350CMEDICAIDFLORIDA
12100505069MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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