Organization · Type 2 NPI

Wal-Mart Stores East LP

Community/Retail Pharmacy · Lebanon, MO

NPI number 1417974833 Active

Practice location

1800 S Jefferson Ave
Lebanon, MO 65536-4208

Call (417) 532-7148 Map

Mailing address

702 SW 8th St
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	2002009385 (MO)

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

6 other providers at this address

Other community/retail pharmacy providers in Lebanon

See all in Lebanon →

NPI record

NPI: 1417974833
Entity type: Organization (Type 2)
Issued: Jul 16, 2006
Last updated: Nov 6, 2023
Status: Active

Other names

<unavail>
Walmart Pharmacy 10-0014 · doing business as
Walmart Pharmacy 10-0014 · doing business as

Authorized official

Matthew McMullin
Director, Contracting
(479) 371-8711

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1417974833

Wal-Mart Stores East LP's National Provider Identifier is 1417974833, issued on Jul 16, 2006. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Lebanon, MO. The record was last updated on Nov 6, 2023.