National Provider Identifier Database

WAL MART STORES EAST LP
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 health care providers, collaborative practice, disease state management, and education classes.


Contact Information

WAL-MART STORES EAST LP
500 S BISHOP AVE
ROLLA, MO65401-4313
Phone: 573-364-4339
Fax:
Website:
Specialty Taxonomy Code
* Community/Retail Pharmacy 3336C0003X
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for WAL-MART STORES EAST LP

NPI Number 1699792911
Legal business name
LBN
WAL-MART STORES EAST LP
Authorized official MATTHEW MCMULLIN - (DIRECTOR, CONTRACTING)
Entity Organization
Organization subpart No
Enumeration date 07/16/2006
Last updated 11/06/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • MO License #: 2002009447
  • MO Medicaid: 601371636
  • Other: 2050242 PK

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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