Wal-mart Stores East Lp
Specialty Pharmacy
2354 Commerce Park Dr Ste 100, Orlando
Florida, 32819-8601
877-453-4566 866-537-0877
Wal-mart Stores East Lp is a Specialty Pharmacy in Orlando, Florida. It is located at 2354 Commerce Park Dr Ste 100, Orlando and it's customer support contact number is 877-453-4566. The authorized person of Wal-mart Stores East Lp is Kimberly Canonic who is Senior Director, Enrollment of the pharmacy and his contact number is 479-371-1168. Active license number of Wal-mart Stores East Lp is OS01543 for Specialty Pharmacy in Arkansas. Wal-mart Stores East Lp accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Wal-mart Stores East Lp is a pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration.
Pharmacy Details:
Wal-mart Stores East Lp type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Wal-mart Stores East Lp |
| Type: | Specialty Pharmacy |
| Location: | 2354 Commerce Park Dr Ste 100, Orlando,
Florida, 32819-8601 |
| Phone: | 877-453-4566 |
| Fax: | 866-537-0877 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Kimberly Canonic |
| Position: | Senior Director, Enrollment |
| Contact Number: | 479-371-1168 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1013934413 |
| NPI Enumeration Date: | 16 Jul, 2006 |
| NPI Last Update On: | 12 Jun, 2025 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Wal-mart Stores East Lp are as mentioned below.
| Specialization | License Number | State | Status | |
| Specialty Pharmacy | OS01543 | Arkansas | Primary | |
| Specialty Pharmacy | 965 | North Dakota | Secondary | |
| Specialty Pharmacy | PHA-MOP-LIC-12447 | Montana | Secondary | |
| Specialty Pharmacy | 262265 | Minnesota | Secondary | |
| Specialty Pharmacy | FL873 | Kentucky | Secondary | |
| Specialty Pharmacy | 054.015021 | Illinois | Secondary | |
| Specialty Pharmacy | 64000468A | Indiana | Secondary | |
| Specialty Pharmacy | PHY.005063-OS | Louisiana | Secondary | |
| Specialty Pharmacy | 22601 | Texas | Secondary | |
| Specialty Pharmacy | 3872 | Tennessee | Secondary | |
| Specialty Pharmacy | 5301007714 | Michigan | Secondary | |
| Specialty Pharmacy | 2003010214 | Missouri | Secondary | |
| Specialty Pharmacy | 99-6096 | Oklahoma | Secondary | |
| Specialty Pharmacy | PH18943 | Florida | Secondary | |
| Specialty Pharmacy | 021368750-03 | Ohio | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 006340 | Medicaid | Florida | |
| 025831800 | Medicaid | Florida | |
| 0311413 | Medicaid | New Jersey | |
| 1013934413 | Medicaid | Alabama | |
| 25831800 | Medicaid | Florida | |
| 80658873 | Medicaid | Colorado | |
| 2015188 | Other | | Pk |
| 3810010863 | Medicaid | Florida | |
| 1013934413 | Medicaid | Florida | |
| 1007455310380 | Medicaid | Pennsylvania | |
| 100445350C | Medicaid | Florida | |
| 100505069 | Medicaid | Florida | |
Medicare Enrollment:
Wal-mart Stores East Lp is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 6204749997 | O20100930049094 | Wal-mart Stores East Lp | DME SUPPLIER - PHARMACY |
Products Available:
Wal-mart Stores East Lp has following products available for sale under medicare.
| Products: |
|---|
| • Blood Glucose Monitors & Supplies: Mail Order | • Blood Glucose Monitors & Supplies: Non-mail Order |
| • Canes & Crutches | • Enteral Nutrients |
| • Ostomy Supplies | • Prosthetic Lenses: Conventional Contact Lenses |
| • Prosthetic Lenses: Conventional Eyeglasses | • Surgical Dressings |
| • Walkers | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 702 Sw 8th St,
Bentonville, Arkansas |
| Zip: | 72716-0445 |
| Phone Number: | 479-277-1242 |
Patients can reach Wal-mart Stores East Lp at
2354 Commerce Park Dr Ste 100, Orlando, Florida or can
call on customer care at 877-453-4566.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.