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WAL-MART STORES EAST LP NPI 1356842512


NPI Information

NPI: 1356842512
Provider Name: WAL-MART STORES EAST LP

Doing Business As: WALMART PHARMACY 10-4561

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 10D2179964

Address:
9550 BAYMEADOWS RD
JACKSONVILLE, FL
ZIP 32256
Phone: (904) 513-5696
Get Directions

WAL-MART STORES EAST LP is a pharmacy in Jacksonville, FL. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. WAL-MART STORES EAST LP NPI is 1356842512. The provider is registered as an organization entity type.
The provider Is Doing Business As Walmart Pharmacy 10-4561.

The provider's business location address is:

9550 BAYMEADOWS RD
JACKSONVILLE, FL
ZIP 32256-710
Phone: (904) 513-5696
Fax: (904) 831-5227

The provider's authorized official is Sarah Little .
The authorized official title is Dir Healthcare Contract & Enrollmen and has the following contact phone number (479) 277-2500.

The CLIA number assigned to this NPI record is 10D2179964 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/23/2018 and was last updated on 7/19/2018.


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
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacyYes

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
12176849OTHERPK

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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