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WAL-MART STORES EAST LP NPI 1750309605


NPI Information

NPI: 1750309605
Provider Name: WAL-MART STORES EAST LP

Doing Business As: WALMART PHARMACY 10-0617

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 15D2129515

Address:
757 W WOLFE ST
SULLIVAN, IN
ZIP 47882
Phone: (812) 268-4626
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WAL-MART STORES EAST LP is a community/retail pharmacy pharmacy in Sullivan, IN. 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 EAST LP NPI is 1750309605. The provider is registered as an organization entity type.
The provider Is Doing Business As Walmart Pharmacy 10-0617.

The provider's business location address is:

757 W WOLFE ST
SULLIVAN, IN
ZIP 47882-116
Phone: (812) 268-4626

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 15D2129515 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/18/2006 and was last updated on 8/24/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail Pharmacy60005022INDIANAYes

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
1100301480AMEDICAIDINDIANA
2100301480MEDICAIDINDIANA
32027172OTHERPK

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

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.