Wal-Mart Pharmacy Store 3422

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

28R103317000 Issued in NJ

Legal business name

WAL-MART PHARMACY STORE 3422

Practice address

2000 Clements Bridge Rd
Deptford, NJ 08096-2016

Phone

(856) 384-6740

Fax

(856) 384-6742

NPI assigned

Jan 23, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Huahua Shi, PHARMD

Title

Pharmacy Manager

Phone

(856) 384-6740

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1093086019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 CLEMENTS BRIDGE RD",
            "city": "DEPTFORD",
            "state": "NJ",
            "postal_code": "080962016",
            "telephone_number": "856-384-6740",
            "fax_number": "856-384-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CLEMENTS BRIDGE RD",
            "city": "DEPTFORD",
            "state": "NJ",
            "postal_code": "080962016",
            "telephone_number": "856-384-6740",
            "fax_number": "856-384-6742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART PHARMACY STORE 3422",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-23",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "SHI",
        "authorized_official_first_name": "HUAHUA",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "856-384-6740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NJ",
            "license": "28R103317000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Varghese, PHARMD
• Luke G Veight, HIS
• Violet Recovery Center LLC
• Sarah Von Lange
• Kelli A Wade, MSW, LCSW
• Wal-Mart Stores East LP
• Wal-Mart Stores, Inc.
• Jennifer Marie Wallace, NURSE PRACTITIONER
• Kaitlyn Weatherby, PT, DPT
• Welcare Pediatrics LLC

• Community Health Clinic/Center in Deptford, NJ
• Providers in Deptford, NJ by specialty
• Community Health Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.