NPIMap

Wal-Mart Stores East LP

Organization Active NPI Community/Retail Pharmacy · Saugus, MA

NPI 1447667142 · NPPES record last updated Aug 30, 2023

Key facts

NPI
1447667142
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
CS89934 (MA)
Legal business name
WAL-MART STORES EAST LP
Practice address
770 Broadway
Saugus, MA 01906-3202
Phone
(781) 816-5377
Fax
(781) 816-5371
NPI assigned
Jul 15, 2014
Organization subpart
No

Authorized official

Name
Sarah Little
Title
Director of Healthcare Contracting
Phone
(479) 277-2500

Other NPIs on the same Medicare enrollment 47

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 47

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2169309Walmart Pharmacy 10-3114
770 Broadway, Saugus, MA 01906		Certificate of waiverJul 17, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Wal-Mart Stores East LP
770 Broadway, Saugus, MA 01906-3202 · (781) 816-5377		 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Ostomy Supplies|Enteral Nutrients|Surgical Dressings Does not accept assignment
Participating since Jul 1, 2014

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20141230002244 MA DME Supplier - Pharmacy 6204749997 Practice locations: Saugus, MA
O20150115002399 MA Part B Supplier - Mass Immunization (Roster Biller Only) 6204749997 48 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Northampton, MA; Northborough, MA; Orange, MA; Pittsfield, MA; Plymouth, MA; Quincy, MA; Raynham, MA; Salem, MA…

National Provider Directory

Tax ID family
Ability Network (4,651 organizations share this tax ID)

Locations

770 Broadway
Saugus, MA 01906
Phone (781) 816-5377

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X CS89934 MA Yes

Addresses

Primary practice location

770 Broadway
Saugus, MA 01906-3202

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0445
Phone (479) 277-2500

Other identifiers

IdentifierTypeStateIssuer
110100897AMedicaidMA
2146973OtherPK

Other names

  • Walmart Pharmacy 10-3114 Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Other providers in Saugus, MA

All providers in Saugus, MA · Community/Retail Pharmacy in Massachusetts

Sources for this page

Verify at the official NPI Registry.