Skip Navigation Link. Please press insert + down arrow if jaws does not start reading the content.

Provider Information for 1831116250


The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

WALMART INC.

Other Names:  
Doing Business As: 
WALMART PHARMACY 10-0039

Organization Subpart: NO

NPI: 1831116250
Last Updated: 2023-11-06
Certification Date: 2023-11-06

Details

NameValue
NPI1831116250
Enumeration Date2006-07-16
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: MATTHEW MCMULLIN
Title: Director, Contracting
Phone: 4793718711
Mailing Address 702 SW 8TH ST
BENTONVILLE, AR 72716-0445
United States

Phone: 479-204-8550 | Fax:479-277-4331
 
Primary Practice Address 2500 S MAIN ST
FORT SCOTT, KS 66701-8724
United States

Phone: 620-223-5051 | Fax:620-223-2193
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
CONNECT URL
https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
2.16.840.1.113883.3.667.2
CMS esMD eMDR Ability Network 100 N 6th St
Minneapolis, MN 55403-1505
United States
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDKS100433090A
Other (non-Medicare)2026505PK
MEDICAIDKS6010831847
MEDICAIDKS606192300
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 332B00000X - Durable Medical Equipment & Medical Supplies
No 333600000X - Pharmacy
Yes 3336C0003X - Pharmacy - Community/Retail PharmacyKS210122