WAL-MART STORES EAST LP (NPI# 1578580783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578580783 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Other Organization Name | WAL-MART PHARMACY 10-1547 |
| Practice Address |
4205 Commerce Dr Lafayette IN 47905-3800 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 7654461278 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2017-02-28 |
| 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 |
60005064 | IN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100301600 | 05 | |
| IN | 100301600A | 05 | |
| PK | 2027136 | 01 |
| Other Name | Type Code |
|---|---|
| WAL-MART PHARMACY 10-1547 | 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 |
4205 COMMERCE DR |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47905-3800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407281 | Lori Anne Fogarty | Pharmacist | 4205 Commerce Dr, Lafayette, IN 47905-3800 | 2020-11-04 |
| 1134729189 | Anna-maureen Aladejebi | Pharmacist | 4205 Commerce Dr, Lafayette, IN 47905-3800 | 2020-10-29 |
| 1720688765 | Melissa Herchenroeder | Pharmacist | 4205 Commerce Dr, Lafayette, IN 47905 | 2020-10-29 |
| 1629678099 | Wendy Shisler | Pharmacist | 4205 Commerce Dr, Lafayette, IN 47905-3800 | 2020-10-27 |
| 1225638695 | Amanda Estelle Muinzer | Pharmacist | 4205 Commerce Dr, Lafayette, IN 47905-3800 | 2020-10-27 |
| 1356679393 | Murley Optometric Inc., P.C. | Optometrist | 4205 Commerce Dr, Lafayette, IN 47905-3800 | 2009-12-03 |
| 1205918125 | Wal-mart Stores East, Lp | Technician/Technologist | 4205 Commerce Dr, Lafayette, IN 47905-3800 | 2006-10-19 |
| 1861507196 | Erin Beth Murley | Optometrist | 4205 Commerce Dr, Lafayette, IN 47905-3800 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
| 1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
| 1255750899 | Emily S Miller | Physical Therapist | 1701 Creasy Ln, Lafayette, IN 47905 | 2014-04-10 |
| 1073876215 | Nathan Webster | Dentist | 1530 Kossuth St., Lafayette, IN 47905 | 2012-06-22 |
| 1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
| 1700177185 | Shannon Tawn Harris | Speech-Language Pathologist | 8900 Cobbler Lane, Lafayette, IN 47905 | 2011-04-20 |
| 1508164484 | David Thomas Beine | Specialist/Technologist | 1321 Unity Pl Ste A, Lafayette, IN 47905 | 2011-03-02 |
| 1447569538 | Deidre Dudley | Nurse Practitioner | 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 | 2010-10-07 |
| 1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
| 1073762969 | Lynette Marie Alexander | Nurse Practitioner | 5500 St Rd. 38 East, Lafayette, IN 47905 | 2008-09-16 |
| Find all providers in zip 47905 | ||||
| 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 |
|---|---|---|---|---|
| 1174008064 | Province Pharmacy Inc | Pharmacy | 5000 Ambassador Caffery Pkwy Ste B, Lafayette, LA 70508-6984 | 2018-09-26 |
| 1700385663 | Ggii Indiana, LLC | Pharmacy | 2250 Teal Rd, Lafayette, IN 47905-2218 | 2018-02-06 |
| 1962914234 | Ksc, Inc | Pharmacy | 526 Highway 52 Byp W, Lafayette, TN 37083-1614 | 2017-10-26 |
| 1447706700 | Medicine Bin Plus LLC | Pharmacy | 1105 West Willow St, Lafayette, LA 70501 | 2016-08-28 |
| 1922493337 | Neighbors Pharmacy | Pharmacy | 6770 Johnston St, Suite-a, Lafayette, LA 70503-6202 | 2015-04-02 |
| 1154663284 | Acadiana Prescription Shop South | Pharmacy | 5000 Ambassador Caffery Pkwy.,bldg 3, Suite B, Lafayette, LA 70508 | 2013-03-27 |
| 1568693505 | Falcon Pharmacy LLC | Pharmacy | 1103 Kaliste Saloom Rd Ste 103, Lafayette, LA 70508-5783 | 2009-08-06 |
| 1659437929 | Kroger Limited Partnership I | Pharmacy | 2200 Greenbush St, Lafayette, IN 47904-2342 | 2006-12-29 |
| 1285730382 | Thrifty Way Pharmacy, Northside Inc. | Pharmacy | 1419 Moss St, Lafayette, LA 70501-3654 | 2006-09-15 |
| 1881798726 | Louisiana Cvs Pharmacy, L.L.C. | Pharmacy | 3754 Moss St, Lafayette, LA 70507-5537 | 2006-09-12 |
| Find all providers in LAFAYETTE | ||||
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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.