Wal-Mart Stores East LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

11121 Issued in NC

Legal business name

WAL-MART STORES EAST LP

Doing business as

Wal-Mart Pharmacy 10-3037

Practice address

905 SE 2ND St
Snow Hill, NC 28580-1634

Phone

(252) 747-2381

NPI assigned

Aug 19, 2011

Last updated

Aug 1, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

WAL-MART STORES INCAs reported in NPPES

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

Authorized official

Name

Laura Levine

Title

MGR of Government Contracting

Phone

(479) 204-8550

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Wal-Mart Pharmacy 10-3037 Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Part of

Wal Mart Pharmacy 10 2039

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

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.

• Badr Mostafa Ibrahim, RPH

  • Pharmacist
  • Snow Hill, NC
  • NPI 1427476936
  NPD (past)
• Christine A Arthur

  • Pharmacist
  • York, PA
  • NPI 1982071015
  NPD (past)

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375315200000",
    "number": "1649550807",
    "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": "727166209",
            "telephone_number": "479-277-1238",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 SE 2ND ST",
            "city": "SNOW HILL",
            "state": "NC",
            "postal_code": "285801634",
            "telephone_number": "252-747-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES EAST LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAL-MART STORES INC",
        "enumeration_date": "2011-08-19",
        "last_updated": "2013-08-01",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "MGR OF GOVERNMENT CONTRACTING",
        "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": "NC",
            "license": "11121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2131607",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wal-Mart Pharmacy 10-3037",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Martia Taylor, LCMHC, LCAS
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• Walgreen Co (Walgreens #21340)
• Holly Alisha Carraway Warren, M.D.
• Georgia Finch Westbrook, PT
• Ayanna Whitfield
• Whitley Bartholomew, DDS, PLLC

• Community/Retail Pharmacy in Snow Hill, NC
• Providers in Snow Hill, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.