WAL-MART STORES EAST LP (NPI# 1508107152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508107152 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Other Organization Name | WAL-MART PHARMACY 10-2488 |
| Practice Address |
1203 6th Ave Se Decatur AL 35601-4011 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 2568226366 |
| Mailing Telephone | 4792046375 |
| Mailing Fax Number | 4792774331 |
| Enumeration Date | 2013-03-06 |
| 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 | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
114080 | AL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 187589 DME | 05 | |
| AL | 148450 | 05 | |
| PK | 2139345 | 01 |
| Other Name | Type Code |
|---|---|
| Wal-Mart Pharmacy 10-2488 | 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 |
1203 6TH AVE SE |
| City | DECATUR |
| State | AL |
| Zip Code | 35601-4011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548551898 | Ryan E Budisalich | Pharmacist | 1203 6th Ave Se, Decatur, AL 35601-4011 | 2011-04-20 |
| 1285173815 | Amanda Mcnutt | Pharmacist | 1203 6th Ave Se, Decatur, AL 35601-4011 | 2017-02-15 |
| 1578012555 | Amy Miller | Pharmacist | 1203 6th Ave Se, Decatur, AL 35601-4011 | 2016-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000679 | Monica Dawn Ross | Counselor | 106 Lee St. Ne, Suite C, Decatur, AL 35601 | 2019-02-23 |
| 1063950319 | Samantha Elizabeth Pickett | Nurse Practitioner | 1115 Beltline Rd Se, Ste 400, Decatur, AL 35601 | 2017-02-07 |
| 1497208250 | Beronica Goodwin | Home Health Aide | 1102b Suite #2 4th Ave Se, Decatur, AL 35601 | 2016-07-28 |
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1104224708 | River City Psychiatry, Inc. | Community/Behavioral Health | 115 Johnston Street, Se, Suite 202, Decatur, AL 35601 | 2014-12-12 |
| 1760882690 | Derrick Aaron Randolph | Registered Nurse | 1207 7th St S.e., Decatur/morgan Hospital - Parkway Campus, Decatur, GA 35601 | 2014-08-28 |
| 1427465434 | Martha Read | Family Medicine | 2208 Danville Rd Sw Ste A, Decatur, AL 35601 | 2014-07-22 |
| 1205242948 | Pure Heart Home Care of Alabama, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 B 14th Street Sw, Decatur, AL 35601 | 2014-07-02 |
| 1720492242 | Christopher John Phillips | Emergency Medicine | 1201 7th Street Se, Decatur, AL 35601 | 2014-06-12 |
| 1366794711 | Complete Dental Decatur LLC | Dentist | 1241 Point Mallard Parkway, Suite. 105, Decatur, AL 35601 | 2012-10-10 |
| Find all providers in zip 35601 | ||||
| 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 |
|---|---|---|---|---|
| 1316565963 | Allen Specialty Pharmacy, Inc | Pharmacy | 1816 S Fm 51 Ste 1600, Decatur, TX 76234-3665 | 2020-07-10 |
| 1801441860 | Rite Care Pharmacy | Pharmacy | 1996 Candler Rd, Decatur, GA 30032-4225 | 2019-08-07 |
| 1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
| 1730605734 | Ganesha Rx Care Group 2, LLC | Pharmacy | 2801 N Decatur Rd Ste 130, Decatur, GA 30033-5949 | 2017-08-21 |
| 1255853784 | Anchor Rx Pharmacy | Pharmacy | 2139 Lawrenceville Hwy, Decatur, GA 30033-4321 | 2017-07-17 |
| 1841532546 | Priceville Pharmacy LLC | Pharmacy | 2941 Point Mallard Pkwy, Suite A, Decatur, AL 35603 | 2013-03-20 |
| 1508106121 | Murks Village Market Inc | Pharmacy | 108b East Delaware Street, Decatur, MI 49045 | 2013-02-19 |
| 1902162548 | Apothecary Sales Inc | Pharmacy | 3220 Highway 31 S Ste A2, Decatur, AL 35603-1731 | 2012-04-09 |
| 1760780233 | Rite Aid | Pharmacy | 1526 6th Av. Se, Decatur, AL 35601-4561 | 2011-03-08 |
| 1285943829 | Victory Pharmacy | Pharmacy | 2280 E William St, Decatur, IL 62521-1528 | 2010-09-30 |
| Find all providers in DECATUR | ||||
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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.