WAL-MART STORES, EAST, LP (NPI# 1760885602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760885602 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES, EAST, LP |
| Other Organization Name | WALMART PHARMACY 10-4306 |
| Practice Address |
934 Highway 79 Dover TN 37058-5962 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 9312322231 |
| Practice Fax Number | 9312329962 |
| Mailing Telephone | 4792771240 |
| Mailing Fax Number | 4792774331 |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2015-05-22 |
| Authorized Official Name | LAURA LEVINE (DIRECTOR OF HEALTHCARE CONTRAC) |
| Authorized Official Telephone | 4792048550 |
| 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 |
00005454 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2149099 | 01 |
| Other Name | Type Code |
|---|---|
| Walmart Pharmacy 10-4306 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134268949 | Wal-mart Stores, East, Lp | Technician/Technologist | 425 Route 31, Macedon, NY 14502 | 2007-02-06 |
| 1649319401 | Wal-mart Stores, East, Lp | Technician/Technologist | 6265 Spencerport Rd, Brockport, NY 14420 | 2007-02-06 |
| Street Address |
934 HIGHWAY 79 |
| City | DOVER |
| State | TN |
| Zip Code | 37058-5962 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023474681 | Rebecca Cravens | Nurse Practitioner | 1511 Donelson Parkway, Dover, TN 37058 | 2016-01-12 |
| 1487894028 | Joselito A Pasaol | Physical Therapist | 402 C Church Street, Dover, TN 37058 | 2009-02-23 |
| 1588809461 | Lakeway Physical Therapy Outpatient, Pllc | Clinic/Center | 402-c Church St., Dover, TN 37058 | 2008-12-08 |
| 1225212350 | Dana M. Earhart | Licensed Practical Nurse | 723 Spring Street, Attn. Dana Earhart, School Nurse, Dover, TN 37058 | 2007-12-26 |
| 1437333614 | Tammy Lagan | Occupational Therapist | 949 Hwy 79, Dover, TN 37058 | 2007-12-24 |
| 1649390956 | Beverly Lynn Lewis | Audiologist | Lewis Hearing Services, 407 A Hwy. 79, Dover, TN 37058 | 2007-03-30 |
| 1689640898 | Price Edwin Hopson Jr. | Dentist | 1021 Spring St, Dover, TN 37058 | 2006-02-27 |
| 1154801207 | Crystal Lynn Shaw | Nurse Practitioner | 1511 Donelson Pkwy, Dover, TN 37058 | 2018-08-17 |
| 1235630112 | Elizabeth Amelia Estock | Registered Nurse | 1021 Spring St, Dover, TN 37058 | 2018-02-26 |
| 1740793736 | Mei-suey Chen | Internal Medicine | 314 Cedar St, Dover, TN 37058 | 2017-11-13 |
| Find all providers in zip 37058 | ||||
| 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 |
|---|---|---|---|---|
| 1548363369 | Ohio Cvs Stores LLC | Pharmacy | 300 Oxford St, Dover, OH 44622-1963 | 2006-09-07 |
| 1588776587 | Neil-kavita Pharmacy Inc | Pharmacy | 233 E Mcfarlan St, Dover, NJ 07801-3603 | 2006-08-31 |
| 1376553883 | Suncoast Community Health Center Inc | Pharmacy | 14254 Sr 574 Bvld, Dover, FL 33527 | 2006-08-08 |
| 1295753275 | Walgreen Co. | Pharmacy | 5506 S Dupont Hwy, Dover, DE 19901-6410 | 2006-07-17 |
| 1720061591 | Neidig Health Care, Ltd | Pharmacy | 710 Boulevard St, Dover, OH 44622-2006 | 2005-11-24 |
| 1023316700 | The Union Hospital Association | Pharmacy | 659 Boulevard St, Dover, OH 44622-2026 | 2011-03-04 |
| 1255438453 | Direct Meds of Dover | Pharmacy | 400 W Blackwell St, Dover, NJ 07801-2525 | 2006-09-20 |
| 1508970393 | Rose Drug of Dover Inc | Pharmacy | 8880 Market St, Pob 335, Dover, AR 72837-9111 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718317 | Rockvegas Enterprises Inc Dba Gateway Pharmacy | Pharmacy | 524 N Gateway Ave, Rockwood, TN 37854-2353 | 2020-10-19 |
| 1124626767 | Knoxville Rx Corp | Pharmacy | 10205 Kingston Pike Ste E, Knoxville, TN 37922-3285 | 2020-10-15 |
| 1073126181 | Off Center, LLC | Pharmacy | 910 Overton Plz, Livingston, TN 38570-1753 | 2020-08-28 |
| 1316557937 | Guardian Pharmacy of Tennessee Three, LLC | Pharmacy | 661 E Lane St Ste B, Shelbyville, TN 37160-3437 | 2020-08-07 |
| 1447860507 | Fph LLC | Pharmacy | 2200 N Central Ave, Humbolt, TN 38343 | 2020-08-04 |
| 1366069965 | Plaza Pharmacy LLC | Pharmacy | 3024 Covington Pike Ste 5, Memphis, TN 38128-5043 | 2020-06-30 |
| 1548886104 | Tumlin Rx, LLC | Pharmacy | 104 E Main Blvd, Church Hill, TN 37642-3724 | 2020-06-19 |
| 1366065278 | Life Well Pharmacy, LLC | Pharmacy | 2408 Susannah St Ste 3, Johnson City, TN 37601-1765 | 2020-05-27 |
| 1699398602 | Walgreen Co | Pharmacy | 262 Danny Thomas Pl Ste 100rx, Memphis, TN 38105-3678 | 2020-05-26 |
| 1053931881 | Jones & Joslin, Pllc | Pharmacy | 4249 Highway 411 Ste 5, Madisonville, TN 37354-1544 | 2020-04-22 |
| 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.