Walmart Pharmacy 10-0056

LBN: Wal-Mart Stores East Lp
Walmart Pharmacy 10-0056 is an health care organization with primary practice located at 1309 Nw 12Th Ave , Ava MO 65608. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Wal-Mart Stores East Lp can be contacted via phone (417) 683-4708, or through Mcmullin, Matthew via phone (479) 371-8711.

Contact Information

Primary practice address
1309 Nw 12Th Ave Ava MO 65608
Phone: (417) 683-4708
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mcmullin, Matthew
Phone: (479) 371-8711

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 2002009527 Missouri

Profile Details

NPI number 1558389056
LBN Legal business name Wal-Mart Stores East Lp
DBA Doing business as Walmart Pharmacy 10-0056
Authorized official Mcmullin, Matthew
Entity Organization
Organization subpart 1 No
Enumeration date Jul 17th, 2006
Last updated Nov 6th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558389056 NPPES
Other 2051415 PK
MEDICAID 603073909 PK

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