MEDICARE: WAL-MART STORES EAST LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	PH15410	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2007600	OTHER		PK

General Provider Information

NPI Number	:	1326065533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAL-MART STORES EAST LP

Provider Business Mailing Address
First Line	:	702 SW 8TH ST
Second Line	:
City	:	BENTONVILLE
State	:	AR
Zip	:	72716-0445
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5001 TAYLOR RD
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-4722
Country	:	US
Telephone Number	:	941-637-8838
Fax Number	:

Authorized Official
Title or Position	:	SENIOR DIRECTOR, ENROLLMENT
Name	:	KIMBERLY CANONIC
Credential	:
Telephone Number	:	480-277-6348

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	06/03/2025

Similar Medicare Providers

1992708739 — DR. SARAH R. SWIATEK PHARM.D.
Practice Location Address:

5001 TAYLOR RD
PUNTA GORDA, FL
33950-4722

Practice Phone: 941-637-8838
Practice Fax:

1285695916 — MICHAEL DAVID WESSON O.D.
Practice Location Address:

5001 TAYLOR ROAD
PUNTA GORDA, FL
33950-4722

Practice Phone: 941-575-0903
Practice Fax: 941-575-0905

1417126111 — WAL-MART STORES EAST, LP
Practice Location Address:

5001 TAYLOR RD
PUNTA GORDA, FL
33950-4722

Practice Phone: 941-575-3525
Practice Fax:

1437606456 — DR. CATINA MURPHY PHARMD
Practice Location Address:

5001 TAYLOR RD
PUNTA GORDA, FL
33950-4722

Practice Phone: 941-637-8838
Practice Fax: 941-637-8848

1396224622 — WILLIAM MACHNICZ
Practice Location Address:

5001 TAYLOR RD
PUNTA GORDA, FL
33950-4722

Practice Phone: 203-858-3353
Practice Fax:

1396207163 — KARISA M CARROLL MD
Practice Location Address:

713 E MARION AVE STE 139
PUNTA GORDA, FL
33950-3863

Practice Phone: 941-833-1750
Practice Fax:

Directions to “WAL-MART STORES EAST LP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.