Organization
WAL-MART STORES EAST LP
Active
Other names
WALMART PHARMACY 10-0088
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW MCMULLIN (DIRECTOR, CONTRACTING)
(479) 371-8711
Entity
Organization
Contact information
Practice address
2100 N MAIN AVE, MOUNTAIN GROVE, MO 65711-2438
(417) 926-4129
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
2002009517
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2050746
PK
—
05
—
602241903
—
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