Wal-Mart Stores East LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0201004657 Issued in VA

Legal business name

WAL-MART STORES EAST LP

Doing business as

Walmart Pharmacy 10-3885

Practice address

5221 Brook Rd
Richmond, VA 23227-2901

Phone

(804) 264-2464

Fax

(804) 264-2575

NPI assigned

May 26, 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 2

Addresses

Other identifiers 2

Other names 1

• Walmart Pharmacy 10-3885 Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

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 10-8256

  • Community/Retail Pharmacy
  • Knoxville, TN
  • NPI 1265459465

  Member Of

  NPD member
• Walmart Inc.

  dba Walmart Pharmacy 10-1588

  • Community/Retail Pharmacy
  • Victorville, CA
  • NPI 1043237456

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487116800000",
    "number": "1952780892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727166209",
            "telephone_number": "479-277-2500",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5221 BROOK RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232272901",
            "telephone_number": "804-264-2464",
            "fax_number": "804-264-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES EAST LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-26",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0201004657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2152249",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952780892",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walmart Pharmacy 10-3885",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joey Anne Roque Waksmunski, LMSW, NBC-HWC
• Wal-Mart Stores East LP (Walmart Pharmacy 10-3869)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2295)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2821)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-4191)
• Wal-Mart Stores East, LP (Vision Center 30-2821)
• Wal-Mart Stores East, LP (Walmart Vision Center 30-4191)
• Wal-Mart Stores East, LP (Vision Center 30-2295)
• Caroline Waldron
• Jennifer Brannan Waldrop, MPT

• Community/Retail Pharmacy in Richmond, VA
• Providers in Richmond, VA by specialty
• Community/Retail Pharmacy in Virginia

• 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.