Wal-Mart Stores East LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P07235 Issued in KY

Legal business name

WAL-MART STORES EAST LP

Doing business as

Wal-Mart Pharmacy 10-3610

Practice address

7100 Raggard Rd
Louisville, KY 40216-1287

Phone

(502) 447-4556

NPI assigned

Jan 16, 2008

Last updated

Feb 16, 2017By 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

Sarah Little

Title

Director of Healthcare Contracting

Phone

(479) 277-2500

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• WAL-MART PHARMACY 10-3610 Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Member of 2

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

• Sams East Inc

  dba Sams Pharmacy 10-8256

  • Community/Retail Pharmacy
  • Knoxville, TN
  • NPI 1265459465

  Member Of

  NPD member
• 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": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1386820710",
    "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": "479-204-8550",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 RAGGARD RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402161287",
            "telephone_number": "502-447-4556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES EAST LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "DIRECTOR OF HEALTHCARE CONTRACTING",
        "authorized_official_telephone_number": "479-277-2500"
    },
    "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": "KY",
            "license": "P07235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2035012",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WAL-MART PHARMACY 10-3610",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wal-Mart Stores East LP (Walmart Pharmacy 10-1170)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-4524)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1269)
• Wal-Mart Stores East LP (Walmart Pharmacy 100589)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3294)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0526)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5418)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-6931)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-4523)

• Community/Retail Pharmacy in Louisville, KY
• Providers in Louisville, KY by specialty
• Community/Retail Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; 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.