Wal-Mart Stores East Lp
Wal-Mart Stores East Lp is a healthcare organization registered as Community/Retail Pharmacy in Cocoa, FL, holding Type 2 (organization) NPI 1689691982 since 2006. The authorized official on file is Matthew Mcmullin, Director, Contracting.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1689691982 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores East Lp |
| Other name | <Unavail> |
| Practice address | 2700 CLEARLAKE RD, Cocoa, FL, 32922 |
| Phone | 3216312823 |
| Fax | 4792774331 |
| Enumeration date | 2006-07-16 |
| Last updated in NPPES | 2023-12-01 |
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 | PH21049 | FL |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 028457200 | Medicaid | FL | — |
| 2004031 | Other | — | PK |
Copy-ready billing details
Provider: Wal-Mart Stores East Lp NPI: 1689691982 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 2700 CLEARLAKE RD, Cocoa, FL, 32922
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1508970534 | Wal-Mart Stores East, Lp | Organization | Optician | Cocoa, FL |
| 1598090540 | Jennifer Tonthat | Individual | Optometrist | Cocoa, FL |
| 1205312733 | George Dagher | Individual | Pharmacist | Cocoa, FL |
| 1568062925 | Brent Kasza | Individual | Pharmacist | Cocoa, FL |
| 1649051376 | Steven Drummond | Individual | Technician | Cocoa, FL |
| 1841040300 | Karen Russ | Individual | Optician | Cocoa, FL |
| 1326988494 | Darrah Potts | Individual | Optician | Cocoa, FL |
Verify this record
Cross-check NPI 1689691982 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 is a Type 2 NPI?
What type of organization is Wal-Mart Stores East Lp?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2023-12-01.