WALMART INC. (NPI# 1588681811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588681811 |
| Entity Type | Organization |
| Organization Name | WALMART INC. |
| Other Organization Name | WALMART PHARMACY 10-2054 |
| Practice Address |
10355 Wicklow Way Jackson CA 95642-9324 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 2092235193 |
| Practice Fax Number | 2092235195 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2018-07-19 |
| 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 |
PHY39651 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2103333 | 01 | |
| CA | 463PHA396510 | 05 |
| Other Name | Type Code |
|---|---|
| WALMART PHARMACY 10-2054 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336661461 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 8270 Delta Shores Cir S, Sacramento, CA 95832-9101 | 2017-07-11 |
| 1710407895 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 6973 Blue Diamond Rd, Las Vegas, NV 89178-9213 | 2017-06-21 |
| 1295265072 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 44100 Jefferson St Ste F, Indio, CA 92201-2715 | 2017-06-14 |
| 1528594983 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 898 S 2550 E, Spanish Fork, UT 84660 | 2017-05-04 |
| 1922533082 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 9600 N Metro Pkwy W, Phoenix, AZ 85051-1402 | 2017-04-26 |
| 1730612425 | Walmart Inc. | Pharmacy | 9400 Ralston Rd, Arvada, CO 80002-2004 | 2017-04-10 |
| 1730628728 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 5210 S Highway 95, Fort Mohave, AZ 86426-9223 | 2017-02-23 |
| 1881132926 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 875 E H St, Chula Vista, CA 91910-7807 | 2017-02-09 |
| 1104364157 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 831 E Fort Lowell Rd, Tucson, AZ 85719-2109 | 2017-02-09 |
| 1588109797 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 5320 10th Ave S, Great Falls, MT 59405-5633 | 2016-12-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | WALMART INC | 708 Sw 8th Street, Bentonville, AR 72716 |
| Colorado Business Entities | Walmart Inc. | 708 Sw 8th Street, Bentonville, AR 72716 |
| Oregon Corporations, Companies and Business Names | WALMART INC. | 708 Sw 8th Street, Bentonville, AR 72716 |
| Iowa Business Entities | WALMART INC. | 708 Sw 8th Street, Bentonville, AR 72716 |
| New York State Corporations | WALMART INC. | 28 Liberty Street, New York, New York 10005 |
| Virginia Business Entities | Walmart Inc. | 702 Sw 8th St, Bentonville, Arkansas 72716-6209 |
| Street Address |
10355 WICKLOW WAY |
| City | JACKSON |
| State | CA |
| Zip Code | 95642-9324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548828049 | Ming Jung | Pharmacist | 10355 Wicklow Way, Jackson, CA 95642-9324 | 2019-05-31 |
| 1700311156 | John Yu | Pharmacist | 10355 Wicklow Way, Jackson, CA 95642-9324 | 2017-04-24 |
| 1306243159 | Yen Tran | Pharmacist | 10355 Wicklow Way, Jackson, CA 95642-9324 | 2014-11-21 |
| 1316355837 | Hoang Pham | Pharmacist | 10355 Wicklow Way, Jackson, CA 95642-9324 | 2014-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932666575 | Gold Country Health Initiative, LLC | Family Medicine | 820/830 State Highway 88, Jackson, CA 95642 | 2019-03-01 |
| 1053844902 | Kathryn Erosa | Pharmacist | 515 Highway 49 South, Jackson, CA 95642 | 2017-04-07 |
| 1356882039 | Thomas Alan Bowhay | Clinic/Center | 820 Highway 88, Jackson, CA 95642 | 2017-03-15 |
| 1710130141 | Roland E Womack | Dentist | 511 Sutter St, Jackson, CA 95642 | 2008-10-29 |
| 1508929522 | Stanley M Ordonez | Dentist | 645 New York Ranch Rd, Jackson, CA 95642 | 2006-12-19 |
| 1942374996 | Thomas W Zeiler | Chiropractor | 665 New York Ranch Rd Suite 2, Jackson, CA 95642 | 2006-11-20 |
| 1023188968 | Cordelia Rose Slayter | Physical Therapist | 711 S State Hwy 49, Jackson, CA 95642 | 2006-11-08 |
| 1285744946 | Raleys | Pharmacy | 781 South Highway 49, Jackson, CA 95642 | 2006-08-30 |
| 1316996747 | Robert R. Bussell X | Physical Therapist | 813 Court Street, Ste 2, Jackon, CA 95642 | 2006-05-10 |
| 1861953135 | Chelsea Yule Solutions | Clinic/Center | 230 N Main St, Jackson, CA 95642 | 2019-03-28 |
| Find all providers in zip 95642 | ||||
| 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 |
|---|---|---|---|---|
| 1144874868 | Whitney Harris Drugs, Inc. | Pharmacy | 1200 Eastover Dr Ste 175, Jackson, MS 39211-6317 | 2019-07-31 |
| 1013576826 | Avita Drugs Mississippi, LLC | Pharmacy | 805 E River Pl Ste A, Jackson, MS 39202-3486 | 2019-06-06 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| 1952823783 | Teton County Hospital District | Pharmacy | 555 E Broadway Ave Ste 212, Jackson, WY 83001-8640 | 2017-07-13 |
| 1477955037 | Jackson Village Pharmacy LLC | Pharmacy | 27 South Cooks Bridge Rd, Suite M1, Jackson, NJ 08527 | 2014-09-25 |
| 1215341623 | Rite Aid | Pharmacy | 702 Bennett Mills Road, Jackson, NJ 08527 | 2014-06-13 |
| 1134251812 | Main Midtown Inc | Pharmacy | 346 E Fortification St, Jackson, MS 39202-2325 | 2007-03-09 |
| 1003943176 | Ljc,inc Dba Stone Drug | Pharmacy | 830 West Broadway, Box 9000, Jackson, WY 83001 | 2007-02-27 |
| 1003968322 | Carel Pharmacy | Pharmacy | 2010 W County Line Rd, Jackson, NJ 08527-2001 | 2007-01-17 |
| 1316095573 | Gold Kimball International, Inc. | Pharmacy | 2080 W County Line Rd, Jackson, NJ 08527-2015 | 2007-01-06 |
| Find all providers in JACKSON | ||||
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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.