WAL-MART STORES EAST LP
NPI 1699792945
Pharmacy - Community/Retail Pharmacy in Maryville, MO

Active since July 16, 2006
1605 S MAIN ST, MARYVILLE, MO 64468(660) 562-3593 Get Directions Write a Review

NPPES record last updated: June 3, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 3, 2025, Feb 20, 2017 (2 updates tracked since 2017).

About Wal-mart Stores East Lp NPPES

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

WAL-MART STORES EAST LP (NPI 1699792945), doing business as Walmart Pharmacy 10-0801, is a healthcare organization registered as a community/retail pharmacy in Maryville, Missouri and active in the NPI registry since July 2006. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1699792945
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address1605 S MAIN STMaryville, MO 64468-2611
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 277-1242
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 277-6348
Enumeration DateJuly 16, 2006
Last NPPES UpdateJune 3, 20252 updates tracked since enumeration
NPPES CertifiedJune 3, 2025
NPI 1699792945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License Licensed in MO · 2002009470
Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
1605 S MAIN ST, Maryville, MO 64468

Other Names 1

Doing Business AsWalmart Pharmacy 10-0801

Other Identifiers 2

Other2050644Pk
Medicaid602167405MO

Accepted Insurance

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
93 services90 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
88 services85 patients

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Walmart Pharmacy 10-0801 carries, from the Medicare DMEPOS supplier directory.

Walmart Pharmacy 10-0801

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

Does not accept Medicare assignment

Walmart Pharmacy 10-0801 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)20491817
Medicare Participant SinceJuly 1, 2014
Supplier Location1605 S Main StMaryville, MO 64468
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 5

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

Optometrist
1605 S MAIN ST, WAL-MART VISION CENTER
MARYVILLE, MO 64468
Pharmacist
1605 S MAIN ST
MARYVILLE, MO 64468
Pharmacist
1605 S MAIN ST
MARYVILLE, MO 64468
Pharmacist
1605 S MAIN ST
MARYVILLE, MO 64468
Eyewear Supplier
1605 S MAIN ST
MARYVILLE, MO 64468

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1699792945, enumerated as an "organization" on July 16, 2006.

The provider is located at 1605 S MAIN ST MARYVILLE, MO 64468 and the phone number is (660) 562-3593.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.