WAL-MART STORES EAST LP (NPI# 1053747071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053747071 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Other Organization Name | WALMART PHARMACY 10-7266 |
| Practice Address |
4924 S Maple Tree Dr Princeton IN 47670-9278 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 8123850757 |
| Practice Fax Number | 8123850759 |
| Mailing Telephone | 4792040709 |
| Mailing Fax Number | 4792774331 |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2017-02-16 |
| Authorized Official Name | SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING) |
| Authorized Official Telephone | 4792772500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
60006362A | IN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2142896 | 01 |
| Other Name | Type Code |
|---|---|
| WalMart Pharmacy 10-7266 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437657426 | Wal-mart Stores East Lp | Pharmacy | 14325 Sw 268th Ter, Homestead, FL 33032-7555 | 2018-01-25 |
| 1003323387 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 73 Fellowship, Mt Laurel, NJ 08054 | 2018-01-08 |
| 1033623236 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 820 Balmy Beach Dr, Apopka, FL 32703-0000 | 2017-11-27 |
| 1477065704 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 337 Pinewood Rd, Sumter, SC 29150-5442 | 2017-10-26 |
| 1841709516 | Wal-mart Stores East Lp | Pharmacy | 1109 W Corbett Ave, Swansboro, NC 28584-8461 | 2017-09-26 |
| 1396264305 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | Nec Landstar and Arbor Meadows Blvd, Orlando, FL 32801-0000 | 2017-09-12 |
| 1720506967 | Wal-mart Stores East Lp | Pharmacy | 955 S Woodland Blvd, Deland, FL 32720-0000 | 2017-09-08 |
| 1164944104 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 7360 Navarre Pkwy, Navarre, FL 32566-7752 | 2017-07-12 |
| 1568984912 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3655 Browns Bridge Rd, Cumming, GA 30028 | 2017-07-07 |
| 1518498534 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 5001 Nine Mile Rd, Richmond, VA 23223-5732 | 2017-03-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Wal-Mart Stores East LP | 702 Sw 8th St, Bentonville, Arkansas 72716-0555 |
| Street Address |
4924 S MAPLE TREE DR |
| City | PRINCETON |
| State | IN |
| Zip Code | 47670-9278 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366725012 | Jana Millikan | Pharmacist | 4924 S Maple Tree Dr, Princeton, IN 47670-9278 | 2011-09-20 |
| 1679173264 | Trent Barrett | Pharmacist | 4924 S Maple Tree Dr, Princeton, IN 47670-9278 | 2020-11-01 |
| 1215537683 | Laura Jane Chambers | Pharmacist | 4924 S Maple Tree Dr, Princeton, IN 47670-9278 | 2020-10-27 |
| 1407456916 | Rachel Dawn Matthews | Pharmacist | 4924 S Maple Tree Dr, Princeton, IN 47670-9278 | 2020-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102384 | Chad Holzmeyer | Pharmacist | 101 W Brumfield Ave., Princeton, IN 47670 | 2020-07-30 |
| 1497383046 | Jessy Roy Emmett | Hearing Instrument Specialist | 205 West State Street, Suite 1, Princeton, IN 47670 | 2020-03-30 |
| 1033643010 | Deaconess Hospital, Inc | Durable Medical Equipment & Medical Supplies | 1416 W. Broadway St, Princeton, IN 47670 | 2017-04-17 |
| 1558782383 | Jon O'keefe | Marriage & Family Therapist | 304 North 5th Avenue, Princeton, IN 47670 | 2013-12-20 |
| 1376828616 | Andrea Catherine Kohlmeyer | Dietitian, Registered | 2340 E 350 S, Princeton, IN 47670 | 2011-10-19 |
| 1710192802 | Sarah Ellen Anderson | Pharmacy Technician | 2005 W Broadway, Princeton, IN 47670 | 2007-05-11 |
| 1760602296 | Buehlers Buy Low Pharmacy | Pharmacy Technician | 2005 W. Broadway, Princeton, IN 47670 | 2007-04-26 |
| 1114066511 | Jon Robb | Pharmacist | 4924 S Maple Tree Drive, Princeton, IN 47670 | 2007-02-05 |
| 1558464172 | M S Krishna | Pediatrics | 312 North 3rd Ave, Princeton, IN 47670 | 2006-09-07 |
| 1255353967 | Gibson County Auditor | Ambulance | 225 N Hart Street, Princeton, IN 47670 | 2006-07-24 |
| Find all providers in zip 47670 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699112284 | Thirumala Group LLC | Pharmacy | 100 W Princeton Dr # A, Princeton, TX 75407-9607 | 2013-05-23 |
| 1235576877 | Thirumala Group LLC | Pharmacy | 201 E Princeton Dr, Princeton, TX 75407-9005 | 2013-05-22 |
| 1538402342 | Wal-mart Stores East Lp | Pharmacy | 509 Doctor Donnie H Jones Jr Blvd W, Princeton, NC 27569-6820 | 2013-03-29 |
| 1043554504 | Walmart Inc. | Pharmacy | 300 21st Ave N, Princeton, MN 55371-6271 | 2012-11-21 |
| 1184862146 | Aydil Healthcare, Pllc | Pharmacy | 501 E Princeton Dr # 100, Princeton, TX 75407 | 2009-01-29 |
| 1396959938 | Princeton Pharmacy, Inc | Pharmacy | 610 N Main Street, Princeton, IL 61356-2006 | 2007-05-10 |
| 1043352537 | Princeton Pharmacy Inc. | Pharmacy | 501 E. Princeton Dr, Suite 100, Princeton, TX 75407 | 2007-02-13 |
| 1568557031 | E. W. James and Sons, Inc | Pharmacy | 550 U. S. Hwy 62 West, Princeton, KY 42445 | 2006-10-03 |
| 1912099516 | New Jersey Cvs Pharmacy LLC | Pharmacy | 881 State Rd # 206, Princeton, NJ 08540-1436 | 2006-09-29 |
| 1366533796 | Hobert Drugs Inc | Pharmacy | 115 N Rum River Dr, Princeton, MN 55371-1616 | 2006-09-28 |
| Find all providers in PRINCETON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.