WAL-MART STORES EAST LP (NPI# 1740466176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740466176 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Other Organization Name | WALMART PHARMACY 10-5444 |
| Practice Address |
10305 Country Club Road Ironwood MI 49938 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 9069324191 |
| Mailing Telephone | 4792048550 |
| Mailing Fax Number | 4792774331 |
| Enumeration Date | 2008-01-16 |
| 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 | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301008794 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3270827 | 05 | |
| PK | 2043626 | 01 | |
| WI | 36226800 | 05 |
| Other Name | Type Code |
|---|---|
| WALMART PHARMACY 10-5444 | 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 |
10305 COUNTRY CLUB ROAD |
| City | IRONWOOD |
| State | MI |
| Zip Code | 49938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750550455 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 10305 Country Club Road, Ironwood, MI 49938 | 2008-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891319661 | Jonathon Rulseh | Physical Therapy Assistant | 10561 Grandview Ln, Ironwood, MI 49938 | 2020-06-08 |
| 1295107704 | Susanna Lee Harris | Counselor | 220 Roosevelt St, Ironwood, MI 49938 | 2015-10-22 |
| 1609214600 | Eve J. Komosa | Physician Assistant | N. 10561 Grand View Lane, Aspirus Grand View, Ironwood, MI 49938 | 2013-06-12 |
| 1255629861 | Tatyana G Bombard | Radiology | Aspirus Ironwood Hospital, N10561 Grand View Lane, Ironwood, MI 49938 | 2011-07-17 |
| 1205140761 | Allison Harr | Advanced Practice Midwife | N 10565 Grandview Lane, Ironwood, MI 49938 | 2010-07-27 |
| 1821267956 | Great Lakes Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 220 Rooselvelt Street, Ironwood, MI 49938 | 2008-02-22 |
| 1215106349 | Great Lakes Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 427 S. Stephenson Avenue, Suite 214, Iron Mountain, MI 49938 | 2008-02-22 |
| 1396811121 | Rebecca Lynn Mika | Occupational Therapist | 1310 E Cloverland Dr, Ironwood, MI 49938 | 2006-11-24 |
| 1306940432 | Marsha Miller Toohey | Chiropractor | 129 E Ayer St, Ironwood, MI 49938 | 2006-09-11 |
| 1326091406 | Sheri L Ewing | Family Medicine | 629 W Cloverland Dr Ste 1, Ironwood, MI 49938 | 2006-05-18 |
| Find all providers in zip 49938 | ||||
| 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 |
|---|---|---|---|---|
| 1992962542 | Walgreen Co | Pharmacy | 802 E Cloverland Dr, Ironwood, MI 49938-1502 | 2008-05-21 |
| 1669582839 | Djcc, Inc. | Pharmacy | 200 E Ayer St, Suite 2, Ironwood, MI 49938-2070 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477389 | Rose Rex LLC | Pharmacy | 2330 S Milford Rd Ste 114, Highland, MI 48357-4982 | 2020-11-08 |
| 1508466194 | Grand Gratiot Pharmacy, LLC | Pharmacy | 7011 Gratiot Ave Ste 100, Detroit, MI 48207-1973 | 2020-10-31 |
| 1104424530 | Advance Care Rx, LLC | Pharmacy | 500 N Cass St, Berrien Springs, MI 49103-1069 | 2020-10-16 |
| 1023616554 | Henry Ford Health System | Pharmacy | 2800 W Grand Blvd, Detroit, MI 48208 | 2020-10-16 |
| 1881292001 | Healthwatch Pharmacy Inc | Pharmacy | 1375 S Lapeer Rd Ste 102, Lake Orion, MI 48360-1421 | 2020-10-09 |
| 1225645781 | Good Choice Pharmacy LLC | Pharmacy | 6750 E 10 Mile Rd, Center Line, MI 48015-1166 | 2020-09-29 |
| 1487269122 | Canfield Pharmacy LLC | Pharmacy | 4673 Conner St, Detroit, MI 48215-2028 | 2020-09-10 |
| 1851905707 | Skidway Pharmacy LLC | Pharmacy | 1830 Greenwood Rd, Prescott, MI 48756-8627 | 2020-09-08 |
| 1023621190 | Azam Mohsen Mesleh | Pharmacy | 6811 Theisen St, Dearborn, MI 48126-1927 | 2020-08-28 |
| 1821606310 | S&k Pharmacy Inc. | Pharmacy | 1916 Davison Rd, Flint, MI 48506-4423 | 2020-07-21 |
| Find all providers with the same taxonomy | ||||
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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.