WAL-MART STORES EAST LP (NPI# 1396762506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396762506 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Other Organization Name | WAL-MART PHARMACY 10-1419 |
| Practice Address |
5311 Coldwater Rd Fort Wayne IN 46825-5444 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 2604844528 |
| 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 |
60005057A | IN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2026975 | 01 | |
| IN | 100081790 | 05 | |
| IN | 100081790A | 05 |
| Other Name | Type Code |
|---|---|
| WAL-MART PHARMACY 10-1419 | 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 |
5311 COLDWATER RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46825-5444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306443007 | Austin Germann | Pharmacist | 5311 Coldwater Rd, Fort Wayne, IN 46825-5444 | 2020-10-06 |
| 1083260913 | Nikhil Patel | Pharmacist | 5311 Coldwater Rd, Fort Wayne, IN 46825-5444 | 2019-08-15 |
| 1245316348 | Amy Lynne Bryan | Optometrist | 5311 Coldwater Rd, Wal-mart Vision Center, Fort Wayne, IN 46825-5444 | 2006-10-31 |
| 1851473086 | Wal-mart Stores East, Lp | Technician/Technologist | 5311 Coldwater Rd, Fort Wayne, IN 46825-5444 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
| 1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| Find all providers in zip 46825 | ||||
| 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 |
|---|---|---|---|---|
| 1659576395 | Kroger Limited Partnership I | Pharmacy | 5300 Decatur Rd, Fort Wayne, IN 46806-3058 | 2007-06-20 |
| 1427253756 | Kroger Limited Partnership I | Pharmacy | 7008 Bluffton Rd, Fort Wayne, IN 46809-2706 | 2007-06-18 |
| 1689879074 | Kroger Limited Partnership I | Pharmacy | 1125 W State Blvd, Fort Wayne, IN 46808-3185 | 2007-06-18 |
| 1578768974 | Kroger Limited Partnership I | Pharmacy | 6310 E State Blvd, Fort Wayne, IN 46815-7023 | 2007-06-18 |
| 1679778989 | Kroger Limited Partnership I | Pharmacy | 10230 Chestnut Plaza Dr, Fort Wayne, IN 46814-8970 | 2007-06-18 |
| 1275737355 | Kroger Limited Partnership I | Pharmacy | 710 E Dupont Rd, Fort Wayne, IN 46825-2056 | 2007-06-13 |
| 1790989879 | Kroger Limited Partnership I | Pharmacy | 4120 N Clinton St, Fort Wayne, IN 46805-1230 | 2007-06-13 |
| 1043414121 | Kroser Limited Phartnership I | Pharmacy | 3105 N Anthony Blvd, Fort Wayne, IN 46805-2227 | 2007-06-13 |
| 1275636961 | Hook Superx LLC | Pharmacy | 2811 Getz Rd, Fort Wayne, IN 46804-3064 | 2006-09-07 |
| 1588767297 | Hook Superx LLC | Pharmacy | 7330 Lima Rd, Fort Wayne, IN 46818-1130 | 2006-09-07 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46825 |
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.