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 1407873714

Wal-Mart Stores East LP is a Durable Medical Equipment & Medical Supplies in St Augustine, Florida. Licensed in Florida. Registered with an NPI since 2006.

Licensed in
FL
In the registry since
2006
Specialties on file
4
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

2355 US Highway 1 S
St Augustine, FL 32086-6072
Phone: (904) 794-4134
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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 PH15457 (FL)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Pharmacy Taxonomy 333600000X
Specialty Pharmacy Taxonomy 3336S0011X

Record details

NPI number1407873714
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Canonic — Senior Director, Enrollment · (480) 277-6348
Other names Walmart Pharmacy 10-0579; Walmart Pharmacy 10-0579
NPI enumeratedJuly 16, 2006
Last updated in NPPESJune 2, 2025
Certification dateJune 2, 2025
Mailing address702 Sw 8th St, Bentonville, AR 72716-0445

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