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Organization
WALMART PHARMACY 0079
Active
Organization
WALMART PHARMACY 0079
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICKEY BOWLES (HEALTH & WELLNESS MARKET MANAGER)
(417) 825-3075
Entity
Organization
Contact information
Practice address
2623 W 7TH ST, JOPLIN, MO 64801-3300
(417) 624-1111
(417) 624-9094
Mailing address
2623 W 7TH ST, JOPLIN, MO 64801-3300
(417) 624-1111
(417) 624-9094
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2009013473
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2009013473
BOARD OF PHARMACY
MO
Enumeration date
11/30/2015
Last updated
11/30/2015
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