National Provider Identifier
Wal-Mart Stores East LP
Wal-Mart Stores East LP is listed in the NPPES registry with a primary specialty of Community/Retail Pharmacy in Rochester, NY and a listed phone number of (585) 266-1640.
Profile Overview
- NPI
- 1225055395
- Provider Type
- Organization
- Primary Specialty
- Community/Retail Pharmacy
- Enumeration Date
- July 16, 2006
- Last Updated
- June 18, 2025
Practice Location
- 1490 Hudson Ave
- Rochester, NY 14621-1701
Phone: (585) 266-1640
Mailing Address
- 702 Sw 8Th St
- Bentonville, AR 72716-0445
Specialties
- Community/Retail Pharmacy (3336C0003X)
- Durable Medical Equipment & Medical Supplies (332B00000X)
- Pharmacy (333600000X)
Endpoints
- https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Connect Url | Other | Ability Network | Minneapolis, MN 55403
2.16.840.1.113883.3.667.22.16.840.1.113883.3.667.2
Full Record
- NPI
- 1225055395
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Wal-Mart Stores East LP
- Other Organization Name
- <Unavail>
- Provider Other Organization Name Type Code
- 6
- Mailing Street Address
- 702 Sw 8Th St
- Mailing City
- Bentonville
- Mailing State
- AR
- Mailing ZIP Code
- 72716-0445
- Mailing Country
- US
- Practice Street Address
- 1490 Hudson Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621-1701
- Practice Country
- US
- Practice Phone
- (585) 266-1640
- Enumeration Date
- July 16, 2006
- Last Updated
- June 18, 2025
- Authorized Official Last Name
- Canonic
- Authorized Official First Name
- Kimberly
- Authorized Official Title
- Senior Director, Enrollment
- Authorized Official Phone
- (480) 853-0515
- Organization Subpart
- No
- Certification Date
- June 18, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Community/Retail Pharmacy (3336C0003X), Durable Medical Equipment & Medical Supplies (332B00000X), Pharmacy (333600000X)
- Other Identifiers
- 2064164 (Pk), 2335431 (NY)