Wal-Mart Stores East LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

11131 Issued in NC

Legal business name

WAL-MART STORES EAST LP

Doing business as

Wal-Mart Pharmacy 10-3036

Practice address

1593 NC Highway 86 N
Yanceyville, NC 27379-8650

Phone

(336) 694-1627

Fax

(336) 694-1226

NPI assigned

Oct 19, 2011

Last updated

Apr 22, 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

Laura Levine

Title

MGR of Government Contracting

Phone

(479) 204-8550

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Wal-Mart Pharmacy 10-3036 Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

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 10-4851

  • Community/Retail Pharmacy
  • Clarksville, IN
  • NPI 1740207117

  Member Of

  NPD member
• Walmart Inc.

  dba WalMart Pharmacy 10-4208

  • Community/Retail Pharmacy
  • Salt Lake City, UT
  • NPI 1326396300

  Member Of

  NPD member

Locations

Practitioners 1

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.

• Carrie Hylton Reed, PHARMD

  • Pharmacist
  • Yanceyville, NC
  • NPI 1124431648
  NPD (past)

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1962787176",
    "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": "479-277-1238",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1593 NC HIGHWAY 86 N",
            "city": "YANCEYVILLE",
            "state": "NC",
            "postal_code": "273798650",
            "telephone_number": "336-694-1627",
            "fax_number": "336-694-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES EAST LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-19",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "MGR OF GOVERNMENT CONTRACTING",
        "authorized_official_telephone_number": "479-204-8550"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "11131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2132395",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wal-Mart Pharmacy 10-3036",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trinity Behavioral Healthcare PC
• Myranda Tuck
• Two Rivers Physician Practices, LLC
• Jill Elaine Van Horn, DO
• Antonia Vincent, LCSW
• Anna Elizabeth Whited, NCMHCA
• David Fielding Willis, M.D.
• Miranda G Worley, PA-C
• WP-Yanceyville Health Holdings, LLC (Caswell House)
• Paul David Wyman, FNP-C

• Community/Retail Pharmacy in Yanceyville, NC
• Providers in Yanceyville, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.