Organization
WAL-MART STORES EAST LP
Active
Other names
WALMART PHARMACY 10-0030
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW MCMULLIN (DIRECTOR, CONTRACTING)
(479) 371-8711
Entity
Organization
Contact information
Practice address
2025 W BUS HIGHWAY 60, DEXTER, MO 63841-2879
(573) 624-5967
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2002009412
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2050063
PK
—
05
—
601371602
—
MO
Enumeration date
07/16/2006
Last updated
11/06/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us