Wal-Mart Stores Texas LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

29375 Issued in TX

Legal business name

WAL-MART STORES TEXAS LLC

Doing business as

Walmart Pharmacy 10-2863

Practice address

1010 N Main St
Winters, TX 79567-3205

Phone

(325) 754-4028

Fax

(325) 754-4723

NPI assigned

Sep 11, 2014

Last updated

Apr 15, 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

Laura Levine

Title

Dir. Healthcare Contracting

Phone

(479) 277-8550

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Walmart Pharmacy 10-2863 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Walmart Inc.

  dba Walmart Pharmacy 10-1588

  • Community/Retail Pharmacy
  • Victorville, CA
  • NPI 1043237456

  Member Of

  NPD member

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429056000000",
    "number": "1316348105",
    "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": "479-277-1240",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N MAIN ST",
            "city": "WINTERS",
            "state": "TX",
            "postal_code": "795673205",
            "telephone_number": "325-754-4028",
            "fax_number": "325-754-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-11",
        "last_updated": "2015-04-15",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "DIR. HEALTHCARE CONTRACTING",
        "authorized_official_telephone_number": "479-277-8550"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "29375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147974",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walmart Pharmacy 10-2863",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Our House Assisted Living Facility
• Residence at Winters LLC
• Lisa Lee Rowlett, LPC
• Dominique Deniece Smith
• Margaret Smith
• Lacey Dee West, FNP-C
• Elizabeth Kay Whitfield, SLP
• Winters Al Operator LLC (Winters Assisted Living)
• Winters HC Operator LLC (Winters Healthcare Residence)
• Winters Isd

• Community/Retail Pharmacy in Winters, TX
• Providers in Winters, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.