NPIMap

Organization Active NPI

Wal-Mart Pharmacy

  • Pharmacist
  • Page, AZ
National Provider Identifier
1619378759
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S016867 Issued in AZ
Legal business name
WAL-MART PHARMACY
Practice address
1017 West Haul
Page, AZ 86040-0656
Phone
(928) 645-2917
NPI assigned
Sep 9, 2014
Last updated
Sep 9, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

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

Authorized official

Name
Stacy Lynn Smith
Title
Pharmacist
Phone
(928) 645-2917

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S016867 AZ Primary

Addresses

Primary practice location

1017 West Haul
Page, AZ 86040-0656

Mailing address

1017 W Haul Rd
Page, AZ 86040
Phone (928) 645-2917

National Provider Directory

National Provider Directory
Tax ID family
Costco Pharmacy44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410220800000",
    "number": "1619378759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 W HAUL RD",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "86040",
            "telephone_number": "928-645-2917",
            "fax_number": "928-645-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 WEST HAUL",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "860400656",
            "telephone_number": "928-645-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-09",
        "last_updated": "2014-09-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "928-645-2917"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S016867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Page, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; 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.