WAL-MART STORES EAST LP (NPI# 1265459317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265459317 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Other Organization Name | WAL-MART PHARMACY 10-1799 |
| Practice Address |
2950 New Pinery Rd Portage WI 53901-9225 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 6087421670 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2017-02-15 |
| 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 |
8184-42 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33186800 | 05 | |
| PK | 2115251 | 01 |
| Other Name | Type Code |
|---|---|
| WAL-MART PHARMACY 10-1799 | 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 |
|---|---|---|
| New York State Retail Food Store | WAL-MART STORES EAST LP | 1400 COUNTY RD 64 HORSEHEADS NY 14845 |
| Street Address |
2950 NEW PINERY RD |
| City | PORTAGE |
| State | WI |
| Zip Code | 53901-9225 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326647272 | Ciaran Patrick Kelly | Pharmacist | 2950 New Pinery Rd, Portage, WI 53901-9225 | 2020-10-21 |
| 1568061745 | Daniel John Sobczak | Pharmacist | 2950 New Pinery Rd, Portage, WI 53901-9225 | 2020-10-20 |
| 1578162954 | Amanda Marie Goodall | Pharmacy | 2950 New Pinery Rd, Portage, WI 53901-9225 | 2020-10-18 |
| 1043391964 | Wal-mart Stores East, Lp | Technician/Technologist | 2950 New Pinery Rd, Portage, WI 53901-9225 | 2006-10-18 |
| 1891802427 | Ronald J. Bound Jr. | Optometrist | 2950 New Pinery Rd, Portage, WI 53901-9225 | 2006-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740710748 | Robert James Corliss | Internal Medicine | St. Vincent Fmc, 140east Cook St., Portage, WI 53901 | 2017-06-13 |
| 1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
| 1871767400 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 132 W. Cook St., Portage, WI 53901 | 2008-04-15 |
| 1881872158 | Marta Jean Jindra | Physical Therapist | 626 E Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1134314552 | Kristina Hellenbrand | Physical Therapist | 2639 New Pinery Road, Suite 2, Portage, WI 53901 | 2007-09-10 |
| 1689727810 | Gregory Allan Bindl | Chiropractor | 2121new Pinery Rd, Portage, WI 53901 | 2007-01-19 |
| 1720149156 | Timothy J Rosin Dds Sc | Dentist | 2570 New Pinery Rd, Portage, WI 53901 | 2006-12-12 |
| 1710083779 | Currani Seubert Dental Office LLC | Dentist | 260 W Cook St, Portage, WI 53901 | 2006-09-16 |
| 1225090525 | University of Wisconsin Medical Foundation Inc | Durable Medical Equipment & Medical Supplies | 2977 Cty Hwy Cx, Portage, WI 53901 | 2006-04-04 |
| Find all providers in zip 53901 | ||||
| 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 |
|---|---|---|---|---|
| 1972082881 | Dean Retail Services, Inc. | Pharmacy | 2825 Hunters Trl Ste 300, Portage, WI 53901-3429 | 2018-08-10 |
| 1386957207 | Tandon's Advanced Pharmacy Inc. | Pharmacy | 7916 Oakland Dr, Portage, MI 49024-4936 | 2010-07-20 |
| 1437252129 | Hook Superx LLC | Pharmacy | 3240 Willowcreek Rd, Portage, IN 46368-5055 | 2006-09-07 |
| 1922015916 | Walgreen Co | Pharmacy | 5995 Us Highway 6, Portage, IN 46368-4945 | 2006-08-02 |
| 1992735666 | Portage Pharmacy, Inc. | Pharmacy | 7966 Lovers Ln, Portage, MI 49002-4446 | 2006-07-05 |
| 1154389302 | Pharma-card, Inc | Pharmacy | 6036 Lute Rd, Suite A, Portage, IN 46368-5008 | 2006-05-03 |
| 1578162954 | Amanda Marie Goodall | Pharmacy | 2950 New Pinery Rd, Portage, WI 53901-9225 | 2020-10-18 |
| 1588048672 | Walgreens | Pharmacy | 5933 S Westnedge Ave, Portage, MI 49002-1455 | 2015-07-17 |
| 1174677611 | Borgess Medical Center | Pharmacy | 7901 Angling Rd, Portage, MI 49024-0714 | 2007-01-22 |
| 1750440756 | Family Fare, LLC | Pharmacy | 525 Romence Rd, Portage, MI 49024-3444 | 2006-12-06 |
| Find all providers in PORTAGE | ||||
Please comment or provide details below to improve the information on WAL-MART STORES EAST LP.
| 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.