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

Wal-Mart Stores East LP

Organization Durable Medical Equipment & Medical Supplies · NPI 1194197533

Wal-Mart Stores East LP is a Durable Medical Equipment & Medical Supplies in Radcliff, Kentucky. Licensed in Kentucky. Registered with an NPI since 2015.

Licensed in
KY
In the registry since
2015
Specialties on file
3
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

102 Gateway Crossing Blvd
Radcliff, KY 40160-9204
Phone: (270) 351-3625
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacy (primary) Taxonomy 333600000X · Licence P07721 (KY)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Community/Retail Pharmacy Taxonomy 3336C0003X

Record details

NPI number1194197533
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Canonic — Senior Director, Enrollment · (480) 277-6348
Other names Walmart Pharmacy 10-5135
NPI enumeratedOctober 26, 2015
Last updated in NPPESJune 10, 2025
Certification dateJune 10, 2025
Mailing address702 Sw 8th St, Mailstop 0445, Bentonville, AR 72716-6209

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