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WAL-MART STORES INC NPI 1619994977


NPI Information

NPI: 1619994977
Provider Name: WAL-MART STORES INC

Doing Business As: WALMART PHARMACY 10-0936

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 14D2140331

Address:
1204 AVENUE OF MID AMERICA
EFFINGHAM, IL
ZIP 62401
Phone: (217) 347-5583
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WAL-MART STORES INC is a community/retail pharmacy pharmacy in Effingham, IL. The provider is 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. WAL-MART STORES INC NPI is 1619994977. The provider is registered as an organization entity type.
The provider Is Doing Business As Walmart Pharmacy 10-0936.

The provider's business location address is:

1204 AVENUE OF MID AMERICA
EFFINGHAM, IL
ZIP 62401-715
Phone: (217) 347-5583

The provider's authorized official is Sarah Little .
The authorized official title is Director Of Healthcare Contracting and has the following contact phone number (479) 277-2500.

The CLIA number assigned to this NPI record is 14D2140331 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/16/2006 and was last updated on 2/17/2017.


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
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail Pharmacy054009015ILLINOISYes

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
10279611860MEDICARE NSC
22019077OTHERPK
3=========936MEDICAIDILLINOIS

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.