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WAL-MART STORES EAST LP NPI 1205241759


NPI Information

NPI: 1205241759
Provider Name: WAL-MART STORES EAST, LP

Other Name: WALMART CARE CLINIC 10-0630

Classification: Nurse Practitioner - 363L00000X
Entity Type: Organization
Address:
230 N BELTLINE DR
FLORENCE, SC
ZIP 29501
Phone: (843) 773-3016
Get Directions

WAL-MART STORES EAST, LP is a nurse practitioner in Florence, SC. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. WAL-MART STORES EAST, LP NPI is 1205241759. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Walmart Care Clinic 10-0630.

The provider's business location address is:

230 N BELTLINE DR
FLORENCE, SC
ZIP 29501-403
Phone: (843) 773-3016
Fax: (843) 679-9694

The provider's authorized official is Laura Levine .
The authorized official title is Director Of Healthcare Contracting and has the following contact phone number (479) 204-8550.

The enumeration date for this NPI number is 6/24/2014 and was last updated on 2/19/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse PractitionerYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1D953OTHERSOUTH CAROLINAMEDICARE PTAN
2GP6499MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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