WAL-MART STORES EAST LP (NPI# 1811914948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811914948 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Other Organization Name | WAL-MART PHARMACY 10-1360 |
| Practice Address |
204 Town Center Rd Fayetteville WV 25840-9540 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 3045741279 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2017-02-15 |
| 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 |
MP0552335 | WV | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2110596 | 01 | |
| WV | 227799002 | 05 | |
| WV | 0227799002 | 05 |
| Other Name | Type Code |
|---|---|
| WAL-MART PHARMACY 10-1360 | 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 |
204 TOWN CENTER RD |
| City | FAYETTEVILLE |
| State | WV |
| Zip Code | 25840-9540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700827144 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 204 Town Center Rd, Fayetteville, WV 25840-9540 | 2006-06-09 |
| 1770183352 | Matthew Wriston | Pharmacist | 204 Town Center Rd, Fayetteville, WV 25840-9540 | 2020-10-31 |
| 1205436664 | Corey Mcpherson | Pharmacist | 204 Town Center Rd, Fayetteville, WV 25840-9540 | 2020-10-27 |
| 1518485564 | Eric Matthew Morris | Pharmacist | 204 Town Center Rd, Fayetteville, WV 25840-9540 | 2017-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447766639 | Nancy Carol Myles | Technician | 171 Wood Rd, Fayetteville, WV 25840 | 2017-12-26 |
| 1598933954 | Kembra Anne Crist | Registered Nurse | 111 Fayette Avenue, Fayette County Boe, Fayetteville, WV 25840 | 2008-02-19 |
| 1003004854 | Edward Lee Winter | Psychologist | 111 Fayette Ave., Fayette County Schools, Fayetteville, WV 25840 | 2007-10-05 |
| 1811109432 | Anita Louise Swanson | Physical Therapist | 111 Fayette Ave, Fayetteville, WV 25840 | 2007-05-04 |
| 1003964008 | Krista L Copenhaver-mackowiak | Nurse Anesthetist, Certified Registered | 613 Crooked Run Rd, Fayetteville, WV 25840 | 2007-01-08 |
| 1922171024 | Carl Arthur Hansen | Dentist | 215 North Court St, Fayetteville, WV 25840 | 2006-11-16 |
| 1932202447 | Appalachian Regional Healthcare | Clinic/Center | 436 Elizabeth Way, Fayetteville, WV 25840 | 2006-09-07 |
| 1154424810 | West Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 72 Whitewater Ave, Fayetteville, WV 25840 | 2006-09-07 |
| 1447241310 | Karen L. Pettry-hultman | Family Medicine | Rr 3 Box 9, Fayetteville, WV 25840 | 2005-10-31 |
| 1598125577 | Jeanne Black | Registered Nurse | 111 Fayette Avenue, Fayette County Schools, Fayetteville, WV 25840 | 2016-03-03 |
| Find all providers in zip 25840 | ||||
| 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 |
|---|---|---|---|---|
| 1639705957 | Cape Fear Discount Drug - Ramsey, LLC | Pharmacy | 4417 Ramsey St, Fayetteville, NC 28311-2134 | 2020-03-18 |
| 1003391491 | Platinum Pharmacy | Pharmacy | 935 Lanier Ave W Ste 1008, Fayetteville, GA 30214-7434 | 2018-10-01 |
| 1649635459 | Walmart Inc. | Pharmacy | 660 W Martin Luther King Blvd, Fayetteville, AR 72701-6443 | 2015-12-21 |
| 1003203878 | R & R Medical Inc | Pharmacy | 2127 N Center St, Suite 1, Fayetteville, AR 72701-9449 | 2015-04-20 |
| 1598171910 | Express Discount Pharmacy LLC | Pharmacy | 1905 Skibo Rd Ste 104, Fayetteville, NC 28314-0261 | 2014-07-07 |
| 1760803035 | Walgreen Co | Pharmacy | 4015 W Wedington Dr, Fayetteville, AR 72704-5733 | 2014-01-03 |
| 1740535715 | Harris Teeter, LLC | Pharmacy | 3050 Traemoor Village Dr, Fayetteville, NC 28306 | 2012-07-17 |
| 1093013591 | Nugen Pharmacy LLC | Pharmacy | 101 Yorktown Dr Ste 102, Fayetteville, GA 30214-1568 | 2011-03-08 |
| 1477880185 | Carlie Cs of Cliffdale LLC | Pharmacy | 690 S Reilly Rd, Fayetteville, NC 28314-5626 | 2009-11-17 |
| 1922246818 | Calhoun Family Pharmacy Inc | Pharmacy | 4417 Ramsey Street, Fayetteville, NC 28311 | 2009-01-30 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 25840 |
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.