Wal-Mart Stores East LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

9157-42 Issued in WI

Legal business name

WAL-MART STORES EAST LP

Doing business as

Walmart Pharmacy 10-2936

Practice address

10330 W Silver Spring Dr
Milwaukee, WI 53225-3248

Phone

(414) 355-1838

Fax

(414) 355-1843

NPI assigned

Jul 16, 2006

Last updated

Feb 15, 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 3

Addresses

Other identifiers 2

Other names 1

• WALMART PHARMACY 10-2936 Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

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

  • Community/Retail Pharmacy
  • San Antonio, TX
  • NPI 1932126059

  Member Of

  NPD member
• Walmart Inc.

  dba Walmart Pharmacy 10-2050

  • Community/Retail Pharmacy
  • Henderson, NV
  • NPI 1043237142

  Member Of

  NPD member

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Francisca Onyeka Ajayi, PHARMD

  • Pharmacist
  • Milwaukee, WI
  • NPI 1285233379
  NPD (past)
• Gagandeep Singh

  • Pharmacist
  • Milwaukee, WI
  • NPI 1073112215
  NPD (past)

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487116800000",
    "number": "1437176500",
    "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": "10330 W SILVER SPRING DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532253248",
            "telephone_number": "414-355-1838",
            "fax_number": "414-355-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES EAST LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2017-02-15",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "9157-42",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33259000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2109966",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALMART PHARMACY 10-2936",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jaquaye Wakefield, PHD
• Martin K. Wakeham, MD
• Lisa Wakeman
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2828)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3496)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2452)
• Wal-Mart Stores East, LP (Vision Center 30-2828)
• Wal-Mart Stores East, LP (Vision Center 30-2936)
• Wal-Mart Stores East, LP (Vision Center 30-2452)
• Eric J Walbergh, MD

• Community/Retail Pharmacy in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.