Wal-Mart Stores East, Lp

Specialty details in registry · Jacksonville, FL

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At a glance

10000 Omni Dr, Jacksonville, FL 32222-4171

NPPES record updated Jul 21, 2026. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

10000 Omni Dr
Jacksonville, FL 32222-4171
Professional details: NPI, taxonomy & registry record
NPI1124996491
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
333600000X
Enumeration date
Oct 28, 2025
Record updated
Jul 21, 2026
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

333600000X · Primary

Specialty details in registry

3336C0003X

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

10000 Omni Dr
Jacksonville, FL 32222-4171
Phone
(904) 934-6904
Mailing address
1 CUSTOMER DR

BENTONVILLE, AR 727160445
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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