NPIMap

Organization Active NPI

Wal-Mart Stores East LP

Doing business as Wal Mart Pharmacies 10-1725

  • Community/Retail Pharmacy
  • Trotwood, OH
National Provider Identifier
1376560557
Registry record updated Dec 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
WAL-MART STORES EAST LP
Doing business as
Wal Mart Pharmacies 10-1725
Practice address
5331 Salem Ave
Wal Mart Pharmacies 10-1725
Trotwood, OH 45426-1625
Phone
(937) 837-5240
Fax
(937) 854-3078
NPI assigned
Jul 16, 2006
Last updated
Dec 28, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
WALMART STORES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 28, 2009

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

Authorized official

Name
Robert Choat
Title
New Store Sys Enrollment
Phone
(179) 273-4885

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 2680500 OH
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

5331 Salem Ave
Wal Mart Pharmacies 10-1725
Trotwood, OH 45426-1625

Mailing address

Mailstop 0445
Bentonville, AR 72716-6209

Other identifiers 2

IdentifierTypeStateIssuer
3655923OtherOTHER ID NUMBER-COMMERCIAL NUMBER
849934MedicaidOH

Other names 1

  • Wal Mart Pharmacies 10-1725 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network4,654 organizations share this tax ID, including this one
Part of
Walmart Pharmacy 10-206

Organizations with this tax ID in the same state 24

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

View all 24

Locations

Mailstop 0445
Bentonville, AR 72716

5331 Salem Ave
#101725
Trotwood, OH 45426
Phone (937) 837-5240

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261958400000",
    "number": "1376560557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MAILSTOP 0445",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727166209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5331 SALEM AVE",
            "address_2": "WAL MART PHARMACIES 10-1725",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454261625",
            "telephone_number": "937-837-5240",
            "fax_number": "937-854-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES EAST LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALMART STORES INC",
        "enumeration_date": "2006-07-16",
        "last_updated": "2009-12-28",
        "status": "A",
        "authorized_official_last_name": "CHOAT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "NEW STORE SYS ENROLLMENT",
        "authorized_official_telephone_number": "179-273-4885"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OH",
            "license": "2680500",
            "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": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3655923",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "849934",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wal Mart Pharmacies 10-1725",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trotwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; 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.