WAL-MART STORES EAST LP (NPI# 1396117735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396117735 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Other Organization Name | WALMART PHARMACY 10-6932 |
| Practice Address |
4701 Northport Blvd Shreveport LA 71107 |
| Mailing Address |
702 Sw 8th St Mailstop 0445 Bentonville AR 72716-0445 |
| Practice Telephone | 3189293071 |
| Mailing Telephone | 4792048550 |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2017-02-21 |
| 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 | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | PHY.007230-RC | LA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2155385 | 01 | |
| LA | 2204173 | 05 |
| Other Name | Type Code |
|---|---|
| Walmart Pharmacy 10-6932 | 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 |
4701 NORTHPORT BLVD |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093322844 | Joseph Thomas Howdeshell | Pharmacist | 4701 Northport Blvd, Shreveport, LA 71107-2539 | 2020-09-25 |
| 1588144521 | Racheal Marie Sparish | Pharmacist | 4701 Northport Blvd, Shreveport, LA 71107-2539 | 2018-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306490875 | Kimber Leigh Lumley | Registered Nurse | 1440 Hawn Ave., Shreveport, LA 71107 | 2019-08-01 |
| 1871063461 | Nicole Capito | Case Manager/Care Coordinator | 200 North Thomas Drive Ste 1, Shreveport, LA 71107 | 2018-11-27 |
| 1891260899 | Danielle Leigh Dreher | Dental Assistant | 3610 Gorman Rd, Shreveport, LA 71107 | 2018-10-05 |
| 1255817540 | Shirley Marie Washington | Technician | 3227 Old Mooringsport Rd., Shreveport Rd, LA 71107 | 2018-07-19 |
| 1366928467 | Katrina L Bailey | Case Manager/Care Coordinator | 1111 Hawn Ave Apt A, Shreveport, LA 71107 | 2018-07-12 |
| 1063907970 | James Mcneely IIi | Public Health or Welfare | 5922 Alaska Ln, Shreveport, LA 71107 | 2018-06-25 |
| 1528560067 | Jacarie Guice | Case Manager/Care Coordinator | 4601 N. Market Ste 2, Shreveport, LA 71107 | 2018-03-01 |
| 1467971069 | Tracy Renard Harris | Counselor | 1149 Englemeade Dr, Shreveport, LA 71107 | 2017-09-14 |
| 1427588045 | Mark Rogers | Behavior Technician | 1500 N. Market Unit C Suite 105, Shreveport, LA 71107 | 2017-06-15 |
| 1356871164 | Hope4youth | Voluntary or Charitable | 2850 King Oaks Loop, Shreveport, LA 71107 | 2017-06-14 |
| Find all providers in zip 71107 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588036552 | Brfhh Shreveport LLC | Pharmacy | 1541 Kings Hwy Rm Eg-10, Shreveport, LA 71103-4228 | 2015-10-29 |
| 1982962890 | Jewella Avenue Pharmacy | Pharmacy | 3610 Jewella Ave, Suite B, Shreveport, LA 71109-4700 | 2012-04-27 |
| 1265675029 | Martin Luther King Health Center | Pharmacy | 1233 Sprague St., Shreveport, LA 71101 | 2009-04-09 |
| 1134272644 | Pill Box Pharmacy Incorporated | Pharmacy | 1849 Line Ave, Shreveport, LA 71101-4611 | 2007-01-19 |
| 1114090446 | Brookshire Grocery Company | Pharmacy | 388 Bert Kouns Loop, Attention Pharmacy Dept, Shreveport, LA 71106-8123 | 2006-11-16 |
| 1952474421 | Brookshire Grocery Company | Pharmacy | 3620 Pines Rd, Attention Pharmacy Dept, Shreveport, LA 71119-5206 | 2006-11-15 |
| 1861565335 | Brookshire Grocery Company | Pharmacy | 510 Kings Hwy, Attention Pharmacy Dept, Shreveport, LA 71104-4444 | 2006-11-15 |
| 1316010887 | Brookshire Grocery Company | Pharmacy | 5828 Line Ave, Attention Pharmacy Dept, Shreveport, LA 71106-1532 | 2006-11-15 |
| 1225101793 | Brookshire Grocery Company | Pharmacy | 3000 N Market St, Attention Pharmacy Dept, Shreveport, LA 71107-4062 | 2006-11-15 |
| 1780757252 | Brookshire Grocery Company | Pharmacy | 2640 Waggoner Ave, Attention Pharmacy Dept, Shreveport, LA 71108-3859 | 2006-11-15 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71107 |
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.