Wal-Mart Stores East Lp
Wal-Mart Stores East Lp is a healthcare organization registered as Community/Retail Pharmacy in Mexico, MO, holding Type 2 (organization) NPI 1215954565 since 2006. The authorized official on file is Matthew Mcmullin, Director, Contracting.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1215954565 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores East Lp |
| Other name | <Unavail> |
| Practice address | 4820 S CLARK ST, Mexico, MO, 65265 |
| Phone | 5735812600 |
| Enumeration date | 2006-07-16 |
| Last updated in NPPES | 2023-11-06 |
Authorized official
| Name | Matthew Mcmullin |
|---|---|
| Title | Director, Contracting |
| Phone | 4793718711 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 333600000X | Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 2002009255 | MO |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 602640609 | Medicaid | MO | — |
| 2051114 | Other | — | PK |
Copy-ready billing details
Provider: Wal-Mart Stores East Lp NPI: 1215954565 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 4820 S CLARK ST, Mexico, MO, 65265
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1063593051 | Wal-Mart Stores East, Lp | Organization | Eyewear Supplier | Mexico, MO |
| 1740311786 | Jerilynn Nichols | Individual | Pharmacist | Mexico, MO |
| 1669072187 | Brianne Rivers | Individual | Pharmacist | Mexico, MO |
| 1649870049 | Linda Mcmanus | Individual | Pharmacist | Mexico, MO |
| 1184224552 | Jessica Simmons | Individual | Pharmacist | Mexico, MO |
| 1104427111 | Sarah Pfaff | Individual | Pharmacist | Mexico, MO |
Verify this record
Cross-check NPI 1215954565 against the authoritative CMS record: view Wal-Mart Stores East Lp on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Wal-Mart Stores East Lp?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2023-11-06.