{"npi":"1689691982","type":"NPI-2","status":"active","name":{"display":"Wal-Mart Stores East Lp","other":[],"organization_name":"WAL-MART STORES EAST LP","authorised_official":"Matthew Mcmullin"},"specialty":{"primary_taxonomy":"3336C0003X","primary_taxonomy_description":"Community/Retail Pharmacy","slug":"community-retail-pharmacy","schema_org_specialty":null,"all":[{"code":"332B00000X","description":"Durable Medical Equipment & Medical Supplies","primary":false,"state":null,"license":null},{"code":"333600000X","description":"Pharmacy","primary":false,"state":null,"license":null},{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":true,"state":"FL","license":"PH21049"}]},"addresses":[{"purpose":"LOCATION","street_1":"2700 CLEARLAKE RD","city":"COCOA","state":"FL","postal_code":"329225716","country_code":"US","phone":"3216312823","fax":"4792774331"},{"purpose":"MAILING","street_1":"702 SW 8TH ST","city":"BENTONVILLE","state":"AR","postal_code":"727160445","country_code":"US"}],"license":{"state":"FL","number":"PH21049"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"028457200","state":"FL","issuer":null},{"type_code":"01","label":"Other","value":"2004031","state":null,"issuer":"PK"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20100930087593","type_code":"30-A5","type_desc":"DME SUPPLIER - PHARMACY","state":"FL","pac_id":"6204749997"}]},"enumeration_date":"2006-07-16","last_updated":"2023-12-01","_meta":{"source":"NPPES","snapshot_date":"2023-12-01","doc_url":"https://findmynpi.com/api"}}