Walmart Pharmacy

Primary specialty

PharmacistTaxonomy code 183500000X

License

05847 Issued in SC

Legal business name

WALMART PHARMACY

Practice address

3812 Liberty Hwy
Anderson, SC 29621-1344

Phone

(864) 231-6071

Fax

(864) 231-6073

NPI assigned

Oct 14, 2014

Organization subpart

Yes

Parent organization

WALMARTAs reported in NPPES

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

Authorized official

Name

Mr. Dennis Van Peterson, R.PH.

Title

Pharmacist

Phone

(864) 231-6071

Specialties & licenses 1

Addresses

Other identifiers 1

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

CLIA laboratory certificates

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413244800000",
    "number": "1750785127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 LIBERTY HWY",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "29621",
            "telephone_number": "864-231-6071",
            "fax_number": "864-231-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3812 LIBERTY HWY",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211344",
            "telephone_number": "864-231-6071",
            "fax_number": "864-231-6073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALMART PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALMART",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-14",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "864-231-6071",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "05847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1234567",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miles Clifton Walker, M ED
• William W Walker, MD
• Lauren Elizabeth Wallick, MA CCC/SLP
• Debbie Walls
• Joseph Spencer Wallwork, DMD
• Kenneth Chet Walters, M.D.
• Shelly Whitaker Walters, APRN
• Wanda'S Private Home Care LLC
• Megan Gawhe Wang, DO
• Steadman A Wang, MD

• Pharmacist in Anderson, SC
• Providers in Anderson, SC by specialty
• Pharmacist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.