Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Wal-Mart Stores East LP

Organization Durable Medical Equipment & Medical Supplies · NPI 1053755314

Wal-Mart Stores East LP is a Durable Medical Equipment & Medical Supplies in Stone Mountain, Georgia. Licensed in Georgia. Registered with an NPI since 2013.

Licensed in
GA
In the registry since
2013
Specialties on file
2
What do these letters mean?
LP — Limited partnership
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5935 Memorial Dr
Stone Mountain, GA 30083-3429
Phone: (404) 260-6149
Fax: (404) 260-6143
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence PHRE009923 (GA)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X

Record details

NPI number1053755314
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Canonic — Senior Director, Enrollment · (480) 277-6348
Other names Wal-Mart Pharmacy 10-3188
NPI enumeratedApril 17, 2013
Last updated in NPPESJune 5, 2025
Certification dateJune 5, 2025
Mailing address702 Sw 8th St, Bentonville, AR 72716-0445

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