<Unavail>

LBN: Wal-Mart Stores East Lp
<Unavail> is an health care organization with primary practice located at 4196 Bemiss Rd , Valdosta GA 31605-7830. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Wal-Mart Stores East Lp can be contacted via phone (229) 588-7577, or through Canonic, Kimberly via phone (480) 853-0515.

Contact Information

Primary practice address
4196 Bemiss Rd Valdosta GA 31605-7830
Fax: (229) 588-7576
Website:
Authorized official contact:
Name: Canonic, Kimberly

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X PHRE010319 Georgia
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1760938013
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 Aug 28th, 2016
Last updated Jun 15th, 2026 - about 4 months ago

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 1760938013 NPPES
Georgia MEDICAID 003182681A
Georgia Other 2164042

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