Walmart

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

051.298761 Issued in IL

Legal business name

WALMART

Practice address

505 Riverstone Pkwy
Kankakee, IL 60901-7207

Phone

(708) 926-4743

NPI assigned

Sep 14, 2015

Last updated

Sep 14, 2015By 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

Amanda Kerr, PHARMD

Title

Pharmacist

Phone

(708) 926-4743

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1861860470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 RIVERSTONE PKWY",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609017207",
            "telephone_number": "708-926-4743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 RIVERSTONE PKWY",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609017207",
            "telephone_number": "708-926-4743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALMART",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-14",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "KERR",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "708-926-4743",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "051.298761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #12468)
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• Walgreen Co. (Walgreens #12468)
• Erin B Walker, MPH,RD, LDN
• Steven Walls
• Walmart Inc. (Walmart Pharmacy 10-4323)
• Renee Walters, D.O
• Delores P Ward, M.S.R.N.
• Faith Ward
• Laura Shanae Washington

• Community/Retail Pharmacy in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.