Organization
WAL-MART STORES EAST LP
Active
Other names
WALMART PHARMACY 10-0092
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW MCMULLIN (DIRECTOR, CONTRACTOR)
(479) 371-8711
Entity
Organization
Contact information
Practice address
3020 S ELLIOTT AVE, AURORA, MO 65605-9663
(417) 678-6006
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
2002009528
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2051417
PK
—
05
—
603155508
—
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