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 1205079100

Wal-Mart Stores East LP is a Durable Medical Equipment & Medical Supplies in Jefferson City, Missouri. Licensed in Missouri. Registered with an NPI since 2009.

Licensed in
MO
In the registry since
2009
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

401 Supercenter Dr
Jefferson City, MO 65101-8190
Phone: (573) 635-3877
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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 2009013741 (MO)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X

Record details

NPI number1205079100
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Canonic — Senior Director, Enrollment · (480) 853-0515
Other names Walmart Pharmacy 10-5477; Walmart Pharmacy 10-5477
NPI enumeratedApril 8, 2009
Last updated in NPPESJune 13, 2025
Certification dateJune 13, 2025
Mailing address702 Sw 8th St, Bentonville, AR 72716-0445

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