Wal-Mart 4134

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

67249 Issued in CA

Legal business name

WAL-MART 4134

Practice address

12840 Beach Blvd
Stanton, CA 90680-4005

Phone

(714) 230-0153

Fax

(714) 230-0134

NPI assigned

Aug 18, 2015

Organization subpart

No

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

Authorized official

Name

Lang Luong

Title

Pharmacy Manager

Phone

(714) 230-0153

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1851767404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12840 BEACH BLVD",
            "city": "STANTON",
            "state": "CA",
            "postal_code": "906804005",
            "telephone_number": "714-230-0153",
            "fax_number": "714-230-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12840 BEACH BLVD",
            "city": "STANTON",
            "state": "CA",
            "postal_code": "906804005",
            "telephone_number": "714-230-0153",
            "fax_number": "714-230-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART 4134",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "LUONG",
        "authorized_official_first_name": "LANG",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "714-230-0153"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "67249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• VN Care Pharmacy, Inc.
• Nadia Vo
• Anh Mai Vu, PHARMD, RPH
• Kim-Uyen Vu, PHARMD
• Nguyen Phuong Vy Vu
• Walgreen Co
• Walmart Inc.
• Qi Wang
• Deanna Marie Ward, SUDRC
• Warren G Ansaldo OD, Apc

• Community/Retail Pharmacy in Stanton, CA
• Providers in Stanton, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.