Walmart Pharmacy 0079

Primary specialty

PharmacistTaxonomy code 183500000X

License

2009013473 Issued in MO

Legal business name

WALMART PHARMACY 0079

Practice address

2623 W 7TH St
Joplin, MO 64801-3300

Phone

(417) 624-1111

Fax

(417) 624-9094

NPI assigned

Nov 30, 2015

Last updated

Nov 30, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mickey Bowles

Title

Health & Wellness Market Manager

Phone

(417) 825-3075

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448841600000",
    "number": "1063886141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2623 W 7TH ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648013300",
            "telephone_number": "417-624-1111",
            "fax_number": "417-624-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2623 W 7TH ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648013300",
            "telephone_number": "417-624-1111",
            "fax_number": "417-624-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALMART PHARMACY 0079",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-30",
        "last_updated": "2015-11-30",
        "status": "A",
        "authorized_official_last_name": "BOWLES",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "HEALTH & WELLNESS MARKET MANAGER",
        "authorized_official_telephone_number": "417-825-3075",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2009013473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "2009013473",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerry W Walker, LPC
• Kevin R Walker, LPC
• Renee A Walker, DO
• Travis D Walker, DO
• Jennifer Walkinshaw, RDH
• Quinn Walsh, LPC
• Emily Walters, MD
• Gabriel J Walters, RPT
• Pamela K Warbinton, O.D.
• Amy Dawn Ward, PMHNP-BC

• Pharmacist in Joplin, MO
• Providers in Joplin, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.