WAL-MART STORES INC (NPI# 1336497312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336497312 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES INC |
| Other Organization Name | WAL-MART PHARMACY 10-5995 |
| Practice Address |
17711 Jean Way Lake Oswego OR 97035-5305 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-6209 |
| Practice Telephone | 5033036878 |
| Mailing Telephone | 4792771238 |
| Mailing Fax Number | 4792774331 |
| Enumeration Date | 2012-08-22 |
| Last Update Date | 2013-08-22 |
| Authorized Official Name | LAURA LEVINE (MGR OF GOVERNMENT CONTRACTING) |
| Authorized Official Telephone | 4792048550 |
| Is Organization Subpart | Y |
| Parent Organization Name | WAL-MART STORES INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
RP-0002733-CS | OR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2136647 | 01 | |
| OR | 500652775 | 05 |
| Other Name | Type Code |
|---|---|
| Wal-Mart Pharmacy 10-5995 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871980219 | Wal-mart Stores Inc | Technician/Technologist | 4425 Venetucci Blvd, Fountain, CO 80906 | 2015-04-23 |
| 1932590999 | Wal-mart Stores Inc | Durable Medical Equipment & Medical Supplies | 605 Orchard Dr, Hillsboro, KS 67063-3502 | 2015-02-12 |
| 1538558994 | Wal-mart Stores Inc | Technician/Technologist | 3460 W Chandler Blvd, Chandler, AZ 85226-5065 | 2015-01-22 |
| 1861897134 | Wal-mart Stores Inc | Durable Medical Equipment & Medical Supplies | 1105 E 15th St, Ellsworth, KS 67439-8548 | 2014-10-29 |
| 1316342686 | Wal-mart Stores Inc | Durable Medical Equipment & Medical Supplies | 120 W Rosewood St, Rose Hill, KS 67133-9301 | 2014-10-29 |
| 1578967212 | Wal-mart Stores Inc | Pharmacy | 1531 E Highway 64, Coal Hill, AR 72832-8704 | 2014-10-09 |
| 1568865368 | Wal-mart Stores Inc | Durable Medical Equipment & Medical Supplies | 720 N Hwy 71, Mansfield, AR 72940 | 2014-10-07 |
| 1497158349 | Wal-mart Stores Inc | Durable Medical Equipment & Medical Supplies | 900 E Ross St, Clearwater, KS 67026-7849 | 2014-10-07 |
| 1952704892 | Wal-mart Stores Inc | Pharmacy | 154 E Roller Ave, Decatur, AR 72722-9446 | 2014-10-07 |
| 1396148243 | Wal-mart Stores Inc | Durable Medical Equipment & Medical Supplies | 505 Housatonic St, Burlington, KS 66839-1712 | 2014-10-07 |
| Street Address |
17711 JEAN WAY |
| City | LAKE OSWEGO |
| State | OR |
| Zip Code | 97035-5305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700127 | Teresa Siebenaler Scott | Social Worker | 3990 Sw Collins Way, Suite 202, Lake Owsego, OR 97035 | 2020-11-04 |
| 1528671567 | Martin Henry Lees | Internal Medicine | 14 Morningview Lane, Lake Oswego, OR 97035 | 2020-08-28 |
| 1356976187 | Premere Rehab LLC | Occupational Therapist | Infinity Rehab - The Springs At Lake Oswego, 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2020-03-12 |
| 1689212193 | Jennifer Chauvin | Nurse Practitioner | 20 Juarez Street, Lake Oswego, OR 97035 | 2019-12-16 |
| 1003396888 | Sarah Guenzburger | Physical Therapist | 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2018-08-21 |
| 1568964252 | Brett Johnson | Marriage & Family Therapist | 5655 Southwood Dr, Lake Oswego, OR 97035 | 2018-03-08 |
| 1912416561 | Michael Paul Long | Social Worker | 14523 Westlake Drive, Lake Oswego, Or 97035, Lake Oswego, OR 97035 | 2017-09-27 |
| 1467807859 | Misty Lohn | Nurse Practitioner | 5 Centerpointe Dr., Ste 600, Lake Oswego, OR 97035 | 2016-05-04 |
| 1326405473 | Kelsey Prince | Behavioral Analyst | 6400 Sw Rosewood St., Portland (lake Oswego), OR 97035 | 2016-01-20 |
| 1942683388 | Elizabeth Risberg Harrison | Massage Therapist | 190 Oswego Summit, Lake Oswego, OR 97035 | 2015-07-02 |
| Find all providers in zip 97035 | ||||
| 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 |
|---|---|---|---|---|
| 1902068216 | Community Compounding Pharmacy | Pharmacy | 6025 Jean Rd, Lake Oswego, OR 97035-5307 | 2008-06-27 |
| 1669596508 | Mountain Park Pharmacy | Pharmacy | 3 Monroe Pkwy Ste O, Lake Oswego, OR 97035-8874 | 2007-03-17 |
| 1972559979 | Haggen Opco North LLC | Pharmacy | 16199 Boones Ferry Rd, Lake Oswego, OR 97035-4201 | 2006-05-25 |
| 1699197459 | Community Compounding Specialty Pharmacy, Inc. | Pharmacy | 6025 Jean Rd, Lake Oswego, OR 97035-5307 | 2014-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972104354 | Jrrx LLC | Pharmacy | 621 Hickory St Nw, Albany, OR 97321-1754 | 2020-11-03 |
| 1346850641 | Credena Health LLC | Pharmacy | 1510 Division St Ste 110, Oregon City, OR 97045-1572 | 2020-08-03 |
| 1235747775 | Cordant Pharmacy Oregon, LLC | Pharmacy | 6135 Ne 80th Ave Ste A2, Portland, OR 97218-4033 | 2020-07-21 |
| 1578184909 | Capsule Portland LLC | Pharmacy | 416 Nw 12th Ave, Portland, OR 97209-2907 | 2020-04-27 |
| 1588291645 | Avita Drugs Oregon, LLC | Pharmacy | 2236 Se Belmont St Ste B, Portland, OR 97214-2817 | 2020-03-26 |
| 1467090183 | Mosaic Medical | Pharmacy | 375 Nw Beaver St Ste 103, Prineville, OR 97754-1802 | 2019-12-12 |
| 1598302119 | Beacon Health Care Solutions Incorporated | Pharmacy | 2790 Broadway Ave, North Bend, OR 97459-2216 | 2019-12-02 |
| 1508337577 | Oregon Health & Science University | Pharmacy | 3303 Sw Bond Ave Rm 1090, Portland, OR 97239-4501 | 2018-12-17 |
| 1588131296 | Home Town Drugs of Cottage Grove, Inc. | Pharmacy | 1205 Hwy 99 North, Cottage Grove, OR 97424 | 2018-10-31 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| Find all providers with the same taxonomy | ||||
| City | LAKE OSWEGO |
| Zip Code | 97035 |
Please comment or provide details below to improve the information on WAL-MART STORES INC.
| 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.