NPIMap

Organization Active NPI

Wal-Mart Pharmacy Inc West

Doing business as Wal-Mart Pharmacy

  • Community/Retail Pharmacy
  • Mount Prospect, IL
National Provider Identifier
1962429241
Registry record updated Feb 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
54011097 Issued in IL
Legal business name
WAL-MART PHARMACY INC WEST
Doing business as
Wal-Mart Pharmacy
Practice address
930 Mount Prospect PLZ
Mt Prospect, IL 60056-2652
Phone
(847) 590-0011
NPI assigned
Jul 16, 2006
Last updated
Feb 2, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
WAL-MART STORES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 2, 2009

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

Authorized official

Name
Dianna Painter
Title
Phy Enrollment Specialist
Phone
(479) 277-1238

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 54011097 IL Primary

Addresses

Primary practice location

930 Mount Prospect PLZ
Mt Prospect, IL 60056-2652

Mailing address

702 SW 8TH St
Bentonville, AR 72716-6209

Other identifiers 1

IdentifierTypeStateIssuer
1460889OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • WAL-MART PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network2,173 organizations share this tax ID, including this one
Part of
Walmart Pharmacy 10-206

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233532800000",
    "number": "1962429241",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 MOUNT PROSPECT PLZ",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600562652",
            "telephone_number": "847-590-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART PHARMACY INC WEST",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAL-MART STORES INC",
        "enumeration_date": "2006-07-16",
        "last_updated": "2009-02-02",
        "status": "A",
        "authorized_official_last_name": "PAINTER",
        "authorized_official_first_name": "DIANNA",
        "authorized_official_title_or_position": "PHY ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "479-277-1238"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "54011097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1460889",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WAL-MART PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Prospect, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; 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.