MEDICARE: WAL-MART STORES EAST, LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician
2	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1811072408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAL-MART STORES EAST, LP

Provider Business Mailing Address
First Line	:	702 SW 8TH STREET
Second Line	:
City	:	BENTONVILLE
State	:	AR
Zip	:	72716-0235
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1021 E PINE ST
Second Line	:
City	:	DEMING
State	:	NM
Zip	:	88030-7009
Country	:	US
Telephone Number	:	505-546-8045
Fax Number	:

Authorized Official
Title or Position	:	NPI COORDINATOR
Name	:	LINDA M. EPPERSON
Credential	:
Telephone Number	:	316-788-5580

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	09/11/2025

Similar Medicare Providers

1356368419 — WAL-MART STORES EAST LP
Practice Location Address:

1021 E PINE ST
DEMING, NM
88030-7009

Practice Phone: 575-546-6746
Practice Fax:

1891101143 — RAJESWARA CHARY PINNOJI
Practice Location Address:

1021 E PINE ST , WALMART
DEMING, NM
88030-7009

Practice Phone: 575-546-6746
Practice Fax: 575-546-6748

1457758385 — DR. HANIFF SEALY PHARMD
Practice Location Address:

1021 E PINE ST
DEMING, NM
88030-7009

Practice Phone: 575-546-6746
Practice Fax:

1629513791 — CARLOS TREVINO
Practice Location Address:

1021 E PINE ST
DEMING, NM
88030-7009

Practice Phone: 575-546-6746
Practice Fax: 575-546-6748

1104334002 — DR. RUBEN U APODACA PHARMD
Practice Location Address:

1021 E PINE ST
DEMING, NM
88030-7009

Practice Phone:
Practice Fax:

1053261479 — MARIAH ARMIDA PACHECO
Practice Location Address:

1419 S SANTA BARBARA ST
DEMING, NM
88030-5361

Practice Phone: 575-936-4227
Practice Fax:

Directions to “WAL-MART STORES EAST, LP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.