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WAL-MART STORES EAST LP NPI 1669499943


NPI Information

NPI: 1669499943
Provider Name: WAL-MART STORES EAST LP

Doing Business As: WALMART PHARMACY 10-2272

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 21D2158587

Address:
2775 DORCHESTER SQ
CAMBRIDGE, MD
ZIP 21613
Phone: (410) 221-0388
Get Directions

WAL-MART STORES EAST LP is a pharmacy in Cambridge, MD. 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 1669499943. The provider is registered as an organization entity type.
The provider Is Doing Business As Walmart Pharmacy 10-2272.

The provider's business location address is:

2775 DORCHESTER SQ
CAMBRIDGE, MD
ZIP 21613-400
Phone: (410) 221-0388
Fax: (410) 221-0462

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 21D2158587 - 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 8/29/2023.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacyP01894MARYLANDYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1465804300MEDICAIDMARYLAND
22035770OTHERPK

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: 5/5/2024

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