WAL-MART STORES EAST LP (NPI# 1114944436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114944436 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Other Organization Name | WAL-MART PHARMACY 10-1293 |
| Practice Address |
3209 Deans Bridge Rd Augusta GA 30906-4201 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 7067967754 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2017-02-28 |
| Authorized Official Name | SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING) |
| Authorized Official Telephone | 4792772500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE007048 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00392169A | 05 | |
| PK | 2017077 | 01 |
| Other Name | Type Code |
|---|---|
| WAL-MART PHARMACY 10-1293 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437657426 | Wal-mart Stores East Lp | Pharmacy | 14325 Sw 268th Ter, Homestead, FL 33032-7555 | 2018-01-25 |
| 1003323387 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 73 Fellowship, Mt Laurel, NJ 08054 | 2018-01-08 |
| 1033623236 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 820 Balmy Beach Dr, Apopka, FL 32703-0000 | 2017-11-27 |
| 1477065704 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 337 Pinewood Rd, Sumter, SC 29150-5442 | 2017-10-26 |
| 1841709516 | Wal-mart Stores East Lp | Pharmacy | 1109 W Corbett Ave, Swansboro, NC 28584-8461 | 2017-09-26 |
| 1396264305 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | Nec Landstar and Arbor Meadows Blvd, Orlando, FL 32801-0000 | 2017-09-12 |
| 1720506967 | Wal-mart Stores East Lp | Pharmacy | 955 S Woodland Blvd, Deland, FL 32720-0000 | 2017-09-08 |
| 1164944104 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 7360 Navarre Pkwy, Navarre, FL 32566-7752 | 2017-07-12 |
| 1568984912 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3655 Browns Bridge Rd, Cumming, GA 30028 | 2017-07-07 |
| 1518498534 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 5001 Nine Mile Rd, Richmond, VA 23223-5732 | 2017-03-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Retail Food Store | WAL-MART STORES EAST LP | 1400 COUNTY RD 64 HORSEHEADS NY 14845 |
| Street Address |
3209 DEANS BRIDGE RD |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30906-4201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104817691 | Gurinder Singh Parmar | Optometrist | 3209 Deans Bridge Rd, Augusta, GA 30906-4201 | 2005-11-02 |
| 1437750064 | Cuong Tung Tu | Pharmacist | 3209 Deans Bridge Rd, Augusta, GA 30906-4201 | 2020-11-02 |
| 1013517051 | Chikelue Tagboo Ezekwueche | Pharmacist | 3209 Deans Bridge Rd, Augusta, GA 30906-4201 | 2020-10-29 |
| 1164649513 | Parmar Eyecare & Assos. P.C. | Optometrist | 3209 Deans Bridge Rd, Augusta, GA 30906-4201 | 2007-04-19 |
| 1063593440 | Wal-mart Stores East, Lp | Technician/Technologist | 3209 Deans Bridge Rd, Augusta, GA 30906-4201 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255969432 | Barton Chapel Dental Group, LLC | Dentist | 2755 Barton Chapel Road, Augusta, GA 30906 | 2020-04-01 |
| 1255897419 | Pediatric Mobility Innovations | Durable Medical Equipment & Medical Supplies | 3114 Augusta Tech Drive Suite 404, Augusta, GA 30906 | 2019-02-13 |
| 1023539731 | Kristy Lee Gibbs | Registered Nurse | 3421 Mike Padgett Hwy Bldg C, Augusta, GA 30906 | 2017-07-03 |
| 1194186031 | Clifton Nane Williams | Counselor | 3230 Hampton Circle, Augusta, GA 30906 | 2016-03-18 |
| 1376929661 | Catherine A. Ganzy | Social Worker | 3405 Mike Padgett Highway; Building 201, East Central Regional Hosptial, Augusta, GA 30906 | 2015-08-10 |
| 1962810358 | Fatemeh Azadeh Paziraei | Dentist | 1631 Gordon Highway, Augusta Smiles Youth Dentistry, Augusta, GA 30906 | 2014-07-29 |
| 1568809770 | Brandon Jennings | Occupational Therapy Assistant | 2388 Old Mcduffie Rd, Augusta, GA 30906 | 2013-05-29 |
| 1811266646 | Eddie P Johnson IIi, Dmd, PC | Preferred Provider Organization | 2755 Barton Chapel Rd, Augusta, GA 30906 | 2011-12-23 |
| 1366739021 | Kerensa A Cooks | Registered Nurse | 3421 Mike Padgett Highway, Serenity Behavioral Health Systems, Augusta, GA 30906 | 2011-07-01 |
| 1265737423 | Pidcock Chiropractic, Inc. | Chiropractor | 3028 Peach Orchard Rd., Augusta, GA 30906 | 2011-01-20 |
| Find all providers in zip 30906 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033716915 | Au Medical Center, Inc. | Pharmacy | 818 Saint Sebastian Way Ste 402, Augusta, GA 30901-2654 | 2020-10-05 |
| 1699308114 | Au Medical Center, Inc. | Pharmacy | 1014 Moore Avenue, Augusta, GA 30912-0001 | 2020-02-13 |
| 1891161246 | Gabiga-jordan LLC | Pharmacy | 4046 Jimmie Dyess Pkwy Ste 100, Augusta, GA 30909-9468 | 2015-08-19 |
| 1962803775 | Bryant and Newsome LLC | Pharmacy | 215 Furys Ferry Rd, Augusta, GA 30907-4718 | 2014-09-11 |
| 1073895496 | Costco Wholesale Corporation | Pharmacy | 825 Cabela Dr, Augusta, GA 30909-8202 | 2011-09-12 |
| 1467732701 | Medex Associates LLC | Pharmacy | 811 13th St Ste 10, Augusta, GA 30901-2771 | 2011-08-18 |
| 1598068967 | Clinical Specialties, LLC | Pharmacy | 318 Baston Rd, Suite 103, Augusta, GA 30907-2978 | 2010-12-07 |
| 1972789311 | Cvs State Capital LLC | Pharmacy | 119 Crossing Way, Augusta, ME 04330-6102 | 2008-01-16 |
| 1184727547 | Georgia Cvs Pharmacy LLC | Pharmacy | 2902 Peach Orchard Rd, Augusta, GA 30906-3504 | 2006-09-07 |
| 1255434072 | Georgia Cvs Pharmacy LLC | Pharmacy | 2559 Windsor Spring Rd, Augusta, GA 30906-4642 | 2006-09-07 |
| Find all providers in AUGUSTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.