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Export Provider Record NPI 1316964679
Wal-Mart Stores East Lp
Organization Subpart: NO
Active
NPI Number1316964679
NPI TypeNPI-2 Organization
SpecialtyPharmacy, Community/Retail Pharmacy
Provider Details
NPI1316964679
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2006-07-16
Last Updated2023-11-06
Authorized OfficialMatthew Mcmullin
DIRECTOR, CONTRACTOR
Phone: 4793718711
Mailing Address702 Sw 8th St
Bentonville, AR 72716-0445
United States
📍 View Map
Primary Practice Address3020 S Elliott Ave
Aurora, MO 65605-9663
United States
Phone: (417) 678-6006
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)-2051417PK
MEDICAIDMO603155508-
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No332B00000X – Durable Medical Equipment & Medical Supplies--
No333600000X – Pharmacy--
Yes3336C0003X – Pharmacy, Community/Retail PharmacyMO2002009528
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About NPI 1316964679

Wal-Mart Stores East Lp is an organization registered in the CMS NPPES NPI Registry with NPI number 1316964679. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Aurora, MO. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-07-16. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1316964679?

NPI 1316964679 belongs to Wal-Mart Stores East Lp, a Pharmacy, Community/Retail Pharmacy in Aurora, MO. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1316964679 active?

The current status of NPI 1316964679 in the NPPES registry is Active. The record was last updated on 2023-11-06.

What specialty is NPI 1316964679?

NPI 1316964679 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1316964679?

You can verify NPI 1316964679 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1316964679?

The primary practice address on file for NPI 1316964679 is 3020 S Elliott Ave, Aurora, MO 65605-9663. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1316964679 issued?

NPI 1316964679 was first issued (enumerated) on 2006-07-16. The NPPES record was last updated on 2023-11-06.

Practice Location Map

Wal-Mart Stores East Lp is located at 3020 S Elliott Ave, Aurora, MO. Use the map below to find directions or verify the practice location.

📍 3020 S Elliott Ave, Aurora, MO 65605-9663  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Wal-Mart Stores East Lp. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1316964679. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pharmacy, Community/Retail Pharmacy2002009528MO
Data Verified from CMS NPPES Last synced: 2026-08-08 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162