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 1407204613

Wal-Mart Stores East LP is a Durable Medical Equipment & Medical Supplies in Summerville, South Carolina. Licensed in South Carolina. Registered with an NPI since 2016.

Licensed in
SC
In the registry since
2016
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

1616 Central Ave
Summerville, SC 29483-9312
Phone: (843) 879-5202
Fax: (843) 879-5201
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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 16919 (SC)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1407204613
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Canonic — Senior Director, Enrollment · (480) 277-6348
Other names Walmart Pharmacy 10-5279
NPI enumeratedMay 27, 2016
Last updated in NPPESJune 10, 2025
Certification dateJune 10, 2025
Mailing address702 Sw 8th St, Mailstop 0445, Bentonville, AR 72716-0445

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