WAL-MART STORES, INC. (NPI# 1639411937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639411937 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES, INC. |
| Other Organization Name | WAL-MART PHARMACY 10-2075 |
| Practice Address |
20120 Pinebrook Blvd Bend OR 97702-2537 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 5413895440 |
| Practice Fax Number | 5413895382 |
| Mailing Telephone | 4792048741 |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2013-03-25 |
| Authorized Official Name | DEB LAUVER (SPECIALIST PLAN ENROLLMENT) |
| Authorized Official Telephone | 4792048741 |
| Is Organization Subpart | N |
| 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 |
Suppliers |
| Other Name | Type Code |
|---|---|
| Wal-Mart Pharmacy 10-2075 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164955852 | Wal-mart Stores, Inc. | Eyewear Supplier (Equipment, not the service) | 9400 Ralston Road, Arvada, CO 80002 | 2017-04-10 |
| 1780039115 | Wal-mart Stores, Inc. | Technician/Technologist | 365 Lake Marian Road, Carpentersville, IL 60110 | 2016-05-04 |
| 1891149332 | Wal-mart Stores, Inc. | Technician/Technologist | 22401 Central Avenue, Richton Park, IL 60471 | 2016-04-21 |
| 1629436233 | Wal-mart Stores, Inc. | Technician/Technologist | 1301 N Victory Pl, Burbank, CA 91502-1649 | 2016-02-10 |
| 1194194605 | Wal-mart Stores, Inc. | Technician/Technologist | 6403 W Pointe Pkwy, Post Falls, ID 83854-5517 | 2015-09-15 |
| 1467837583 | Wal-mart Stores, Inc. | Technician/Technologist | 303 E Moody Rd, Rexburg, ID 83440 | 2015-07-30 |
| 1760882666 | Wal-mart Stores, Inc. | Technician/Technologist | 82-491 Avenue 42, Indio, CA 92203 | 2014-08-27 |
| 1568879419 | Wal-mart Stores, Inc. | Technician/Technologist | 5200 W 60th Street N, Sioux Falls, SD 57107-6504 | 2014-07-11 |
| 1508283730 | Wal-mart Stores, Inc. | Technician/Technologist | 1424 Highway 2 E, Devils Lake, ND 58301-4000 | 2014-03-26 |
| 1396169041 | Wal-mart Stores, Inc. | Technician/Technologist | 2552 W. 75th Street, Naperville, IL 60540-0000 | 2014-02-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | WAL-MART STORES, INC. | 702 Sw 8th Street, Bentonville, AR 72716 |
| Vermont Business Registrations | WAL-MART STORES, INC. | 702 Sw 8th Street, Bentonville, AR 72716 |
| Massachusetts Corporations | WAL-MART STORES, INC. | 702 Sw 8th Street, Bentonville, AR 72716 |
| Oklahoma Business Registrations | WAL-MART STORES, INC. | 702 Sw 8th St, Bentonville, AR 72716 |
| Street Address |
20120 PINEBROOK BLVD |
| City | BEND |
| State | OR |
| Zip Code | 97702-2537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457398315 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 20120 Pinebrook Blvd, Bend, OR 97702-2537 | 2006-06-01 |
| 1508383381 | Goulding Eyecare LLC | Optometrist | 20120 Pinebrook Blvd, Bend, OR 97702-2537 | 2017-08-23 |
| 1639532880 | Robert Mote | Pharmacist | 20120 Pinebrook Blvd, Bend, OR 97702-2537 | 2016-04-04 |
| 1265893937 | Susie Ann Jones | Pharmacist | 20120 Pinebrook Blvd, Bend, OR 97702 | 2016-03-09 |
| 1386003622 | Susie Nosler | Pharmacist | 20120 Pinebrook Blvd, Bend, OR 97702-2537 | 2016-02-15 |
| 1912306481 | Donald Byrne | Pharmacist | 20120 Pinebrook Blvd, Bend, OR 97702-2537 | 2014-08-20 |
| 1073920955 | Tedd Marceau | Pharmacist | 20120 Pinebrook Blvd, Bend, OR 97702-2537 | 2014-07-12 |
| 1053749937 | Eyes In Motion | Optometrist | 20120 Pinebrook Blvd, Bend, OR 97702 | 2013-10-31 |
| 1518268234 | Keith Daugherty | Pharmacist | 20120 Pinebrook Blvd, Bend, OR 97702-2537 | 2010-11-11 |
| 1235210691 | Wal-mart Stores, Inc. | Technician/Technologist | 20120 Pinebrook Blvd, Bend, OR 97702-2537 | 2006-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629676259 | Amy Michelle Anderson | Counselor | 233 Sw Wilson Ave, Ste 201, Bend, OR 97702 | 2020-10-15 |
| 1386259463 | Jacob Rehder | Counselor | 19717 Mt Batchelor Dr, #226, Bend, OR 97702 | 2020-09-15 |
| 1497385215 | Capacity Performance Therapy | Physical Medicine & Rehabilitation | 61125 Lodgepole Dr., Bend, OR 97702 | 2020-01-21 |
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1609435049 | Praxis Medical Group Inc | Orthopaedic Surgery | 1140 Sw Simpson Avenue, Suite 100, Bend, OR 97702 | 2019-06-10 |
| 1013485754 | Elana Leah Pesah | Social Worker | 138 Maaglei Harim Levin, Jerusalem, ISRAEL 97702 | 2018-11-12 |
| 1104303239 | Kyleigh Mcvey | Massage Therapist | 999 Sw Disk Dr, Bend, OR 97702 | 2018-07-21 |
| 1477042869 | Siloe Castaneda Huerta | Counselor | 1340 Nw Wall, Bend, Or, Bend, OR 97702 | 2018-05-02 |
| 1164910808 | Rebecca M Joyce | Social Worker | 1011 Sw Emkay Dr. Suite 101, Bend, OR 97702 | 2018-04-27 |
| 1093217978 | Jennifer Bury | Acupuncturist | 296 Sw Columbia St Ste D1, Bend, OR 97702 | 2018-03-06 |
| Find all providers in zip 97702 | ||||
| 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 |
|---|---|---|---|---|
| 1710304043 | Westside Pharmacy Inc | Pharmacy | 359 Sw Century Dr, Bend, OR 97702-1054 | 2014-03-25 |
| 1528213790 | Cascade Apothecary Inc | Pharmacy | 19550 Amber Meadow Dr Ste 170, Bend, OR 97702-3527 | 2008-12-01 |
| 1467658864 | Haggen Opco North LLC | Pharmacy | 61155 S Hwy 97, Bend, OR 97702-2523 | 2007-06-22 |
| 1881704401 | Costco Wholesale Corporation | Pharmacy | 2500 Ne Highway 20, Bend, OR 97701 | 2006-08-30 |
| 1407953805 | St. Charles Health Systems | Pharmacy | 2500 Ne Neff Rd, Bend, OR 97701-6015 | 2006-09-20 |
| 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 | ||||
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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.