WAL-MART STORES EAST LP (NPI# 1073530267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073530267 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Other Organization Name | WALMART PHARMACY 10-0390 |
| Practice Address |
275 Walton Dr Waverly TN 37185-3382 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 9312969984 |
| Practice Fax Number | 9312969986 |
| Mailing Telephone | 4792048550 |
| Mailing Fax Number | 4792774331 |
| Enumeration Date | 2006-07-16 |
| 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 | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
C2897 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1454020 | 05 | |
| PK | 2091600 | 01 |
| Other Name | Type Code |
|---|---|
| WALMART PHARMACY 10-0390 | 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 |
275 WALTON DR |
| City | WAVERLY |
| State | TN |
| Zip Code | 37185-3382 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114421237 | Lacey Dunkley Freeman I | Pharmacist | 275 Walton Dr, Waverly, TN 37185-3382 | 2018-03-22 |
| 1154825669 | Ambra Lynn Wilson | Pharmacist | 275 Walton Dr, Waverly, TN 37185-3382 | 2018-03-20 |
| 1023512589 | Kimberley Oatsvall Townsend | Pharmacist | 275 Walton Dr, Waverly, TN 37185-3382 | 2018-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104295567 | Tiffany Szabo | Speech-Language Pathologist | 670 Tn- 13, Waverly, TN 37185 | 2015-09-16 |
| 1407266653 | Wallace Mcclure | General Practice | 450 Powers Blvd., Waverly, TN 37185 | 2014-04-28 |
| 1982995346 | Laurel Lea Barrier | Speech-Language Pathologist | 1171 Lockhart Road, Waverly, TN 37185 | 2011-04-20 |
| 1477703155 | Christie Madge King-patterson | Nurse Practitioner | 215b Holly Lane, Waverly, TN 37185 | 2008-09-30 |
| 1396921946 | Tammy Jo Saffel | Counselor | 205b East Main Street, Waverly, TN 37185 | 2008-01-14 |
| 1386794816 | Lawrence Richard Jackson Jr. | Family Medicine | 102 Hillwood Dr, Waverly, TN 37185 | 2007-01-10 |
| 1720147119 | Kelley M Blackwell | Marriage & Family Therapist | 795 Holly Ln, Waverly, TN 37185 | 2006-12-08 |
| 1063509578 | Ida Suellen Westerman | Counselor | 205 B East Main Street, Waverly, TN 37185 | 2006-10-06 |
| 1801835962 | Noel R Dominguez | Internal Medicine | 209 West Main Street, Waverly, TN 37185 | 2006-06-05 |
| 1730145822 | Waverly Health Care and Rehabilitation Center Inc | Skilled Nursing Facility | 895 Powers Blvd, Waverly, TN 37185 | 2006-04-26 |
| Find all providers in zip 37185 | ||||
| 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 |
|---|---|---|---|---|
| 1487727293 | Four Star Drug of Waverly | Pharmacy | 13851 Guildford St, Suite D, Waverly, NE 68462 | 2006-11-17 |
| 1497302350 | Back Home Pharmacy Inc | Pharmacy | 328 W Main St, Waverly, VA 23890-3235 | 2019-08-23 |
| 1699255620 | Pharmhouse LLC | Pharmacy | 306 W Main St, Waverly, TN 37185-1513 | 2018-08-20 |
| 1083759963 | Main Street Drug LLC | Pharmacy | 211 West Main Street, Waverly, TN 37185-1510 | 2007-02-20 |
| 1750474938 | Waverly Pharmacy LLC | Pharmacy | 328 W Main St, Waverly, VA 23890-3235 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718317 | Rockvegas Enterprises Inc Dba Gateway Pharmacy | Pharmacy | 524 N Gateway Ave, Rockwood, TN 37854-2353 | 2020-10-19 |
| 1124626767 | Knoxville Rx Corp | Pharmacy | 10205 Kingston Pike Ste E, Knoxville, TN 37922-3285 | 2020-10-15 |
| 1073126181 | Off Center, LLC | Pharmacy | 910 Overton Plz, Livingston, TN 38570-1753 | 2020-08-28 |
| 1316557937 | Guardian Pharmacy of Tennessee Three, LLC | Pharmacy | 661 E Lane St Ste B, Shelbyville, TN 37160-3437 | 2020-08-07 |
| 1447860507 | Fph LLC | Pharmacy | 2200 N Central Ave, Humbolt, TN 38343 | 2020-08-04 |
| 1366069965 | Plaza Pharmacy LLC | Pharmacy | 3024 Covington Pike Ste 5, Memphis, TN 38128-5043 | 2020-06-30 |
| 1548886104 | Tumlin Rx, LLC | Pharmacy | 104 E Main Blvd, Church Hill, TN 37642-3724 | 2020-06-19 |
| 1366065278 | Life Well Pharmacy, LLC | Pharmacy | 2408 Susannah St Ste 3, Johnson City, TN 37601-1765 | 2020-05-27 |
| 1699398602 | Walgreen Co | Pharmacy | 262 Danny Thomas Pl Ste 100rx, Memphis, TN 38105-3678 | 2020-05-26 |
| 1053931881 | Jones & Joslin, Pllc | Pharmacy | 4249 Highway 411 Ste 5, Madisonville, TN 37354-1544 | 2020-04-22 |
| Find all providers with the same taxonomy | ||||
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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.