WAL-MART STORES EAST LP

Community/Retail Pharmacy

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

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Contact Information

WAL-MART STORES EAST LP

1042 MANCHESTER EXPY
COLUMBUS, GA 31904-6571

Phone: 706-330-5353
Fax: 706-330-5352
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Community/Retail Pharmacy	3336C0003X	58	Medical Supply Company with Pharmacist
Durable Medical Equipment & Medical Supplies	332B00000X	54	Other Medical Supply Company

Indicates primary specialty

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NPI Profile & details for WAL-MART STORES EAST LP

NPI # 1619347564

LBN Legal business name WAL-MART STORES EAST LP

Authorized official KIMBERLY CANONIC - (SENIOR DIRECTOR, ENROLLMENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/05/2015

Last updated 06/10/2025 - About 12 months ago

Identifiers

GA	License #	PHRE010255
AL	Medicaid	215114
GA	Medicaid	003171388A
	Other	2154731	PK

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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