Wal-mart Stores East Lp
Pharmacy
4840 Outer Loop, Louisville
Kentucky, 40219-3302
502-313-6350 502-313-6349
Wal-mart Stores East Lp is a Pharmacy in Louisville, Kentucky. It is located at 4840 Outer Loop, Louisville and it's customer support contact number is 502-313-6350. 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 480-277-6348. Active license number of Wal-mart Stores East Lp is P07790 for Pharmacy in Kentucky. 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 facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
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: | Pharmacy |
| Location: | 4840 Outer Loop, Louisville,
Kentucky, 40219-3302 |
| Phone: | 502-313-6350 |
| Fax: | 502-313-6349 |
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: | 480-277-6348 |
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: | 1720536790 |
| NPI Enumeration Date: | 19 Sep, 2016 |
| NPI Last Update On: | 06 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 | |
| Pharmacy | P07790 | Kentucky | Primary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
| Community/Retail Pharmacy | | | 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 |
| 2164253 | Other | | Pk |
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 | O20170125002248 | 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: Non-mail Order | • Canes & Crutches |
| • Enteral Nutrients | • Ostomy Supplies |
| • 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: | 479-204-8550 |
| Fax Number: | 479-277-4331 |
Patients can reach Wal-mart Stores East Lp at
4840 Outer Loop, Louisville, Kentucky or can
call on customer care at 502-313-6350.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.