WAL-MART STORES EAST LP (NPI# 1366469579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366469579 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Other Organization Name | WALMART PHARMACY 10-2493 |
| Practice Address |
5859 28th St Se Grand Rapids MI 49546-6905 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 6169499892 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2017-02-20 |
| 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 |
5301006458 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2043455 | 01 | |
| MI | 2356207 | 05 |
| Other Name | Type Code |
|---|---|
| WALMART PHARMACY 10-2493 | 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 |
5859 28TH ST SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-6905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992473 | Jessica Abdou | Pharmacist | 5859 28th St Se, Grand Rapids, MI 49546-6905 | 2020-11-02 |
| 1104426592 | Laura Sue Smith | Pharmacist | 5859 28th St Se, Grand Rapids, MI 49546-6905 | 2020-10-27 |
| 1760848303 | Alice Karasiewic | Pharmacist | 5859 28th St Se, Grand Rapids, MI 49546-6905 | 2016-01-12 |
| 1376918284 | Christopher Kowalski | Pharmacist | 5859 28th St Se, Grand Rapids, MI 49546-6905 | 2015-12-02 |
| 1891198768 | Timothy Kumapayi | Pharmacist | 5859 28th St Se, Grand Rapids, MI 49546 | 2014-10-06 |
| 1376718296 | Hisham N Sahom | Pharmacist | 5859 28th St Se, Grand Rapids, MI 49546-6905 | 2008-04-23 |
| 1013049584 | Robert B Witham | Pharmacist | 5859 28th St Se, Grand Rapids, MI 49546-6905 | 2007-03-11 |
| 1003992249 | Wal-mart Stores East, Lp | Technician/Technologist | 5859 28th St Se, Grand Rapids, MI 49546-6905 | 2006-10-31 |
| 1558464537 | Rebecca J Colburn | Optometrist | 5859 28th St Se, Grand Rapids, MI 49546-6905 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| 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 |
|---|---|---|---|---|
| 1518504091 | East Paris Pharmacy, LLC | Pharmacy | 2060 E Paris Ave Se Ste 102, Grand Rapids, MI 49546-6113 | 2019-12-04 |
| 1588229058 | Grand Rapids Rx LLC | Pharmacy | 1000 E Paris Ave Se Ste 104, Grand Rapids, MI 49546-3680 | 2019-05-09 |
| 1073950994 | Cet Pharmacy Grand Rapids LLC | Pharmacy | 2060 E Paris Ave Se Ste 110, Grand Rapids, MI 49546-6113 | 2013-06-01 |
| 1619209004 | Family Fare, LLC | Pharmacy | 2022 Apple Orchard Dr Ne, Grand Rapids, MI 49525-9785 | 2010-02-10 |
| 1235257387 | Cancer and Hematology Centers of Western Mi, P.C. | Pharmacy | 145 Michigan Ave Ne, Suite 3100, Grand Rapids, MI 49503 | 2007-03-27 |
| 1720160518 | Nudak Ventures LLC | Pharmacy | 417 Nw 1st Ave, Grand Rapids, MN 55744-2617 | 2006-10-20 |
| 1871693218 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 1155 Fuller Ave Ne, Grand Rapids, MI 49503-1362 | 2006-09-25 |
| 1114027448 | Family Fare, LLC | Pharmacy | 1225 Leonard St Ne, Grand Rapids, MI 49505-5510 | 2006-09-25 |
| 1760582092 | Family Fare, LLC | Pharmacy | 5241 Northland Dr Ne, Grand Rapids, MI 49525-1041 | 2006-09-25 |
| 1679673909 | Family Fare, LLC | Pharmacy | 2755 Lake Michigan Dr Nw, Grand Rapids, MI 49504-5872 | 2006-09-25 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
Please comment or provide details below to improve the information on WAL-MART STORES EAST LP.
| 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.