<Unavail>

LBN: Wal-Mart Stores East Lp
<Unavail> is an health care organization with primary practice located at 10550 Old Saint Augustine Rd , Jacksonville FL 32257-8660. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Wal-Mart Stores East Lp can be contacted via phone (904) 380-8274, or through Canonic, Kimberly via phone (480) 277-6348.

Contact Information

Primary practice address
10550 Old Saint Augustine Rd Jacksonville FL 32257-8660
Phone: (904) 380-8274
Fax: (904) 380-8275
Website:
Map and Directions
Authorized official contact:
Name: Canonic, Kimberly
Phone: (480) 277-6348

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Community/Retail Pharmacy 3336C0003X PH26851 Florida

Profile Details

NPI number 1316289283
LBN Legal business name Wal-Mart Stores East Lp
DBA Doing business as <Unavail>
Authorized official Canonic, Kimberly
Entity Organization
Organization subpart 1 No
Enumeration date Mar 19th, 2013
Last updated Jun 9th, 2025 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316289283 NPPES
Florida MEDICAID 008850700
Florida Other 2140145

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