Wal-Mart Stores East LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5724 Issued in TN

Legal business name

WAL-MART STORES EAST LP

Doing business as

Walmart Pharmacy 10-4671

Practice address

4110 Shallowford Rd
Chattanooga, TN 37411-1110

Phone

(423) 242-0019

Fax

(423) 242-0006

NPI assigned

Nov 5, 2015

Last updated

Feb 15, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sarah Little

Title

Director of Healthcare Contracting

Phone

(479) 277-2500

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Walmart Pharmacy 10-4671 Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Member of 2

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

• Sams East Inc

  dba Sams Pharmacy

  • Community/Retail Pharmacy
  • San Antonio, TX
  • NPI 1932126059

  Member Of

  NPD member
• Walmart Inc.

  dba Walmart Pharmacy 10-2050

  • Community/Retail Pharmacy
  • Henderson, NV
  • NPI 1043237142

  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.

• Arpankumar R Gajjar

  • Pharmacist
  • Chattanooga, TN
  • NPI 1629575196
  NPD (past)
• Taylor Renee Kirkland, PHARMD

  • Pharmacist
  • Madisonville, TN
  • NPI 1073111241
  NPD (past)

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487116800000",
    "number": "1780057240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "address_2": "MAILSTOP 0445",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160445",
            "telephone_number": "479-204-1258",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 SHALLOWFORD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374111110",
            "telephone_number": "423-242-0019",
            "fax_number": "423-242-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES EAST LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-05",
        "last_updated": "2017-02-15",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "DIRECTOR OF HEALTHCARE CONTRACTING",
        "authorized_official_telephone_number": "479-277-2500"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "5724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155642",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walmart Pharmacy 10-4671",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wal-Mart Stores East LP (Walmart Pharmacy 10-5251)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-3619)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3660)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3659)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1469)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5143)
• Wal-Mart Stores East, LP (Vision Center 30-3660)
• Wal-Mart Stores East, LP (Vision Center 30-5251)
• Wal-Mart Stores East, LP (Vision Center 30-3659)
• Wal-Mart Stores East, LP (Vision Center 30-1469)

• Community/Retail Pharmacy in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; 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.