Wal-Mart Stores East LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

51-6875 Issued in OK

Legal business name

WAL-MART STORES EAST LP

Doing business as

Walmart Pharmacy 10-3756

Practice address

124 E Columbia St
Okemah, OK 74859-2801

Phone

(918) 623-9207

Fax

(918) 623-9221

NPI assigned

Oct 9, 2014

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

Dr. Healthcare & Enrollment

Phone

(479) 204-8550

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Walmart Pharmacy 10-3756 Doing business as

Member of 2

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

• Sams East Inc

  dba Sams Pharmacy 10-4851

  • Community/Retail Pharmacy
  • Clarksville, IN
  • NPI 1740207117

  Member Of

  NPD member
• Walmart Inc.

  dba WalMart Pharmacy 10-4208

  • Community/Retail Pharmacy
  • Salt Lake City, UT
  • NPI 1326396300

  Member Of

  NPD member

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1487058129",
    "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": "479-277-2500",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E COLUMBIA ST",
            "city": "OKEMAH",
            "state": "OK",
            "postal_code": "748592801",
            "telephone_number": "918-623-9207",
            "fax_number": "918-623-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES EAST LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-09",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "DR. HEALTHCARE & ENROLLMENT",
        "authorized_official_telephone_number": "479-204-8550"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "51-6875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2149232",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100816310F",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walmart Pharmacy 10-3756",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donald Lee Thomas, REHAB SPECIALIST
• Virginia Tiger
• Ryan Titsworth
• Austin James Tucker
• Judi K Unterkircher
• Winter Angeline Wells, PA-C
• Brett Alan Wessel, DC
• Christopher Michael Robert Wires, PT, DPT
• Nova Deere Wise
• Lisha Joy Worley

• Community/Retail Pharmacy in Okemah, OK
• Providers in Okemah, OK by specialty
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; 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.