DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: WAL-MART STORES EAST LP

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
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0003XCommunity/Retail Pharmacy2002010322MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12050725OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326065673
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAL-MART STORES EAST LP
Provider Business Mailing Address
First Line : 702 SW 8TH ST
Second Line :
City : BENTONVILLE
State : AR
Zip : 72716-0445
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1433 S SAM HOUSTON BLVD
Second Line :
City : HOUSTON
State : MO
Zip : 65483-2131
Country : US
Telephone Number : 417-967-4521
Fax Number :
Authorized Official
Title or Position : DIRECTOR, CONTRACTING
Name : MATTHEW MCMULLIN
Credential :
Telephone Number : 479-371-8711
Provider Enumeration Date : 07/16/2006
Last Update Date : 12/01/2023

Similar Medicare Providers

1790866507 — WAL-MART STORES EAST, LP
Practice Location Address:
1433 S SAM HOUSTON BLVD
HOUSTON, MO
65483-2131
Practice Phone: 417-967-3302
Practice Fax:
1295052694 — JARED THOMAS MATTHEWS PHARMD
Practice Location Address:
1433 S SAM HOUSTON BLVD
HOUSTON, MO
65483-2131
Practice Phone: 417-967-4521
Practice Fax: 417-967-3598
1598366452 — JENNIFER RENEE LEGGINS PHARMD
Practice Location Address:
1433 S SAM HOUSTON BLVD
HOUSTON, MO
65483-2131
Practice Phone: 417-967-4521
Practice Fax:
1659972610 — DR. JOHN D HUFF PHARMD
Practice Location Address:
1433 S SAM HOUSTON BLVD
HOUSTON, MO
65483-2131
Practice Phone: 417-967-4521
Practice Fax: 417-967-3598
1831035997 — ZACHARY BROOKS
Practice Location Address:
1433 S SAM HOUSTON BLVD
HOUSTON, MO
65483-2131
Practice Phone: 417-967-4521
Practice Fax:
1548253370 — GREYSTONE MEDICAL SERVICES
Practice Location Address:
2131 SARAH ST
HOUSTON, TX
77054-3804
Practice Phone: 713-795-0665
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.