WALMART PHARMACY 0079
NPI 1063886141
Pharmacist in Joplin, MO

Active since November 30, 2015CLIA 26D2143245 · Waiver
2623 W 7TH ST, JOPLIN, MO 64801(417) 624-1111(417) 624-9094 Get Directions Write a Review

NPPES record last updated: November 30, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Walmart Pharmacy 0079 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALMART PHARMACY 0079 (NPI 1063886141) is a healthcare organization registered as a pharmacist in Joplin, Missouri and active in the NPI registry since November 2015. The organization holds a CLIA Waiver certificate valid through January 25, 2028 and lists Mickey Bowles, Health & Wellness Market Manager, as its authorized official.

NPPES Registry Identity

NPI1063886141
Entity TypeOrganization
Primary Taxonomy183500000X
Legal Business NameWALMART PHARMACY 0079
Location Address2623 W 7TH STJoplin, MO 64801-3300
Mailing Address2623 W 7th StJoplin, MO 64801-3300 · (417) 624-1111 · Fax (417) 624-9094
Fax(417) 624-9094
Organization SubpartNo
Authorized OfficialMickey BowlesHealth & Wellness Market Manager · (417) 825-3075
Enumeration DateNovember 30, 2015
NPI 1063886141 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in MO · 2009013473
Definition

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

2623 W 7TH ST, Joplin, MO 64801

Other Identifiers 1

Other2009013473MO · Board Of Pharmacy

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2143245

Walmart Pharmacy 10-79 · Joplin, MO
Active · expires Jan 25, 2028
CLIA Number26D2143245
Laboratory TypePharmacy
Certificate Effective DateJanuary 26, 2026
Certificate Expiration DateJanuary 25, 2028
Laboratory DirectorShannon R. Beachner
Laboratory Phone(479) 277-2374
Laboratory LocationWalmart Pharmacy 10-792623 West 7th Street, Joplin, MO 64801
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Wal Mart Pharmacy 10 0079 carries, from the Medicare DMEPOS supplier directory.

Wal Mart Pharmacy 10 0079

DMEPOS supplier · Joplin, MOOperated by Wal-Mart Stores East, LP

Does not accept Medicare assignment

Wal Mart Pharmacy 10 0079 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20492027
Medicare Participant SinceJuly 1, 2014
Supplier Location2623 W 7th StJoplin, MO 64801
Supplier Specialties
Pharmacy Optician

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
2623 W 7TH ST
JOPLIN, MO 64801
Eyewear Supplier
2623 W 7TH ST
JOPLIN, MO 64801
Pharmacist
2623 W 7TH ST
JOPLIN, MO 64801
Pharmacist
2623 W 7TH ST
JOPLIN, MO 64801
Pharmacy (Community/Retail Pharmacy)
2623 W 7TH ST
JOPLIN, MO 64801
Pharmacist (Pharmacotherapy)
2623 W 7TH ST
JOPLIN, MO 64801
Optometrist
2623 W 7TH ST
JOPLIN, MO 64801

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Walmart Pharmacy 0079's NPI number?

The NPI number for Walmart Pharmacy 0079 is 1063886141. It was assigned to this organization in the NPPES registry on November 30, 2015.

Where is Walmart Pharmacy 0079 located?

Walmart Pharmacy 0079 is located at 2623 W 7th St, Joplin, MO 64801. The listed phone number is (417) 624-1111.

What is Walmart Pharmacy 0079's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

Does Walmart Pharmacy 0079 accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Wal Mart Pharmacy 10 0079 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Walmart Pharmacy 0079 hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2143245) is associated with this NPI, valid through January 25, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Walmart Pharmacy 0079 was last updated on November 30, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.