Wal-Mart

Primary specialty

PharmacistTaxonomy code 183500000X

License

14180 Issued in LA

Legal business name

WAL-MART

Practice address

17585 Airline Hwy
Prairieville, LA 70769

Phone

(225) 677-7390

Fax

(225) 677-7390

NPI assigned

Aug 15, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Robert Charles Deveer Jr., RPH

Title

Pharmacist

Phone

(225) 278-3166

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408060800000",
    "number": "1669871562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17585 AIRLINE HWY",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "70769",
            "telephone_number": "225-677-7390",
            "fax_number": "225-677-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17585 AIRLINE HWY",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "70769",
            "telephone_number": "225-677-7390",
            "fax_number": "225-677-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-15",
        "last_updated": "2014-08-15",
        "status": "A",
        "authorized_official_last_name": "DEVEER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "225-278-3166",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "14180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylie Elizabeth Verdun
• Megan Vessell
• Victoria'S Heart LLC
• W Trent Massengale, MD LLC
• Haylie D'Nea Wagoner, PLPC
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co

• Pharmacist in Prairieville, LA
• Providers in Prairieville, LA by specialty
• Pharmacist in Louisiana

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