NPIMap

Organization Active NPI

Wal-Mart Stores Inc

  • Community/Retail Pharmacy
  • Mandan, ND
National Provider Identifier
1285073486
Registry record updated Jun 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
WAL-MART STORES INC
Doing business as
Wal-Mart Pharmacy 10-2033
Practice address
1000 Old Red TRL NE
Mandan, ND 58554-1591
Phone
(701) 354-6964
Fax
(701) 354-6965
NPI assigned
Jun 20, 2013
Organization subpart
Yes
Parent organization
WAL-MART STORES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 23, 2013

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

Authorized official

Name
David Badeen
Title
Sr Dir H&W
Phone
(479) 277-2611

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1000 Old Red TRL NE
Mandan, ND 58554-1591

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0445
Phone (479) 204-8741

Other identifiers 1

IdentifierTypeStateIssuer
2140892OtherPK

Other names 1

  • Wal-Mart Pharmacy 10-2033 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network2,173 organizations share this tax ID, including this one
Part of
Walmart Pharmact

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

1000 Old Red Trl NE
Mandan, ND 58554
Phone (701) 354-6964

NPI Registry JSON

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371945600000",
    "number": "1285073486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160445",
            "telephone_number": "479-204-8741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 OLD RED TRL NE",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585541591",
            "telephone_number": "701-354-6964",
            "fax_number": "701-354-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAL-MART STORES INC",
        "enumeration_date": "2013-06-20",
        "last_updated": "2013-06-23",
        "status": "A",
        "authorized_official_last_name": "BADEEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "SR DIR H&W",
        "authorized_official_telephone_number": "479-277-2611"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140892",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wal-Mart Pharmacy 10-2033",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mandan, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2013; 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.