WAL-MART STORES EAST LP (NPI# 1104843309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104843309 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Other Organization Name | WAL-MART PHARMACY 10-2572 |
| Practice Address |
990 W Emmitt Ave Waverly OH 45690-1095 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 7409470300 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2017-02-20 |
| 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 |
021036400 | OH | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2041598 | 05 | |
| PK | 2074900 | 01 |
| Other Name | Type Code |
|---|---|
| WAL-MART PHARMACY 10-2572 | 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 |
990 W EMMITT AVE |
| City | WAVERLY |
| State | OH |
| Zip Code | 45690-1095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770795 | Thomas David Kelley | Pharmacist | 990 W Emmitt Ave, Waverly, OH 45690-1095 | 2020-11-05 |
| 1841891256 | Jennifer Elliott | Pharmacist | 990 W Emmitt Ave, Waverly, OH 45690-1095 | 2020-11-03 |
| 1528668084 | Whitney Detillion | Pharmacist | 990 W Emmitt Ave, Waverly, OH 45690-1095 | 2020-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538767181 | Brandie Mustard | Homemaker | 3018 My Tabor Rd, Waverly, OH 45690 | 2020-10-15 |
| 1225661168 | Kyle Colley | Counselor | 14574 Us Hughway 23, Waverly, OH 45690 | 2020-02-19 |
| 1366082513 | Ryan Rawlins | Counselor | 14574 St. Rt. 23, Waverly, OH 45690 | 2020-01-15 |
| 1700424140 | Jaime Wooldridge | Counselor | 14532 St. Rt. 23, Waverly, OH 45690 | 2019-12-17 |
| 1518513415 | Jacquelyn Irene Sprouse | Counselor | 217 Emmitt Ave, Waverly, OH 45690 | 2019-08-15 |
| 1639634850 | Krista K Leeth | Counselor | 14532 Us Hwy 23, 14534 Us Hwy 23, Waverly, OH 45690 | 2019-02-01 |
| 1881196244 | Kevin Michael Reichert | Counselor | Pike County Recovery Council, 218 East North Street, Waverly, OH 45690 | 2018-03-01 |
| 1619483179 | Ticia Lewis | Counselor | 14532 State Route 23, Waverly, OH 45690 | 2017-12-20 |
| 1205342136 | Criston B Evans | Licensed Practical Nurse | 14532 Us Highway 23, Waverly, OH 45690 | 2017-12-14 |
| 1447763313 | Jody Ryan Colley | Counselor | 14572 St. Rt. 23, Waverly, OH 45690 | 2017-11-14 |
| Find all providers in zip 45690 | ||||
| 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 |
|---|---|---|---|---|
| 1295335024 | Hux Enterprises | Pharmacy | 641 Hill Rd N Ste C, Pickerington, OH 43147-9346 | 2020-10-30 |
| 1891302626 | Uc Healthcare System | Pharmacy | 222 Piedmont Ave Ste 2000, Cincinnati, OH 45219-4231 | 2020-09-25 |
| 1619580966 | Lcrg Bros LLC | Pharmacy | 7584 E Main St, Reynoldsburg, OH 43068-1208 | 2020-08-26 |
| 1528686763 | Lorain Chemists Inc | Pharmacy | 3815 Lorain Ave, Cleveland, OH 44113-3710 | 2020-07-13 |
| 1699397646 | D & G Partners LLC | Pharmacy | 7623 E Main St, Reynoldsburg, OH 43068-1209 | 2020-05-13 |
| 1992325567 | The Kroger Co | Pharmacy | 3255 Eden Ave, Suite 336, Cincinnati, OH 45229 | 2020-04-23 |
| 1689200461 | Cross Point Pharmacy | Pharmacy | 800 Cross Pointe Rd Ste P, Gahanna, OH 43230-6690 | 2020-03-12 |
| 1245870864 | Bravo Rx Pharmacy | Pharmacy | 4125 W Broad St # B, Columbus, OH 43228-1600 | 2020-01-11 |
| 1235777350 | Tan Thai Inc | Pharmacy | 4300 Clime Rd Ste 111, Columbus, OH 43228-6491 | 2019-12-19 |
| 1144868597 | Blanchard Valley Regional Health Center | Pharmacy | 930 Sheriden Dr Ste C, Carey, OH 43316-1502 | 2019-12-17 |
| 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.