WAL-MART STORES EAST LP (NPI# 1770500951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770500951 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Other Organization Name | WALMART PHARMACY 10-0676 |
| Practice Address |
1102 N Gateway Ave Rockwood TN 37854-4012 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 8653541571 |
| Practice Fax Number | 8653541987 |
| Mailing Telephone | 4792048550 |
| Mailing Fax Number | 4792774331 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2017-02-16 |
| 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 |
02062 | TN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1454041 | 05 | |
| PK | 2090722 | 01 |
| Other Name | Type Code |
|---|---|
| WALMART PHARMACY 10-0676 | 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 |
|---|---|---|
| Virginia Business Entities | Wal-Mart Stores East LP | 702 Sw 8th St, Bentonville, Arkansas 72716-0555 |
| Street Address |
1102 N GATEWAY AVE |
| City | ROCKWOOD |
| State | TN |
| Zip Code | 37854-4012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083194542 | Mitchell Brown | Optometrist | 1102 N Gateway Ave, Rockwood, TN 37854-4012 | 2018-08-15 |
| 1255829701 | Kenneth Edward Scarbrough | Pharmacist | 1102 N Gateway Ave, Rockwood, TN 37854-4109 | 2018-04-30 |
| 1467940049 | Mark Andrew Moore | Pharmacist | 1102 N Gateway Ave, Rockwood, TN 37854-4109 | 2018-04-29 |
| 1801969688 | Shay Delson Williams | Optometrist | 1102 N Gateway Ave, Rockwood, TN 37854-4012 | 2006-11-17 |
| 1083796981 | Wal-mart Stores East, Lp | Technician/Technologist | 1102 N Gateway Ave, Rockwood, TN 37854-4012 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245500917 | Assurance Professional Billing Services | Specialist | 236 Burke Mill Rd, Rockwood, TN 37854 | 2012-01-11 |
| 1639407489 | Robert Sloan Hicks Jr. | Pharmacist | 225 West Rockwood St., Live and Let Live Drug Store, Rockwood, TN 37854 | 2009-12-04 |
| 1255477741 | Janet Eldridge Isham | Licensed Practical Nurse | 1362 N. Gateway Ave, Rockwood, TN 37854 | 2007-01-30 |
| 1154439271 | James Larry Brewer | Dentist | 1124 N Gateway Ave, Rockwood, TN 37854 | 2006-08-28 |
| 1750808093 | Cynthia Dawn Clark | Nurse Practitioner | 1420 N Gateway Ave, Rockwood, TN 37854 | 2017-08-28 |
| 1568772754 | Summit Medical Group, Pllc | Internal Medicine | 1420 North Gateway Ave, Rockwood, TN 37854 | 2010-10-21 |
| 1841348547 | Darrell Eugene Cates Jr. | Dentist | 1546 Gateway Ave., Rockwood, TN 37854-0003 | 2007-01-08 |
| 1033264411 | Sherry G Hill | Pharmacist | 225 W Rockwood St, Rockwood, TN 37854-2243 | 2007-01-24 |
| 1487003455 | Live and Let Live Drug Store, Inc | Durable Medical Equipment & Medical Supplies | 225 W Rockwood St, Rockwood, TN 37854-2243 | 2016-06-09 |
| 1851434666 | Jessica Ruthanne Kilgore | Pharmacist | 225 W Rockwood St, Rockwood, TN 37854-2243 | 2007-02-14 |
| Find all providers in zip 37854 | ||||
| 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 |
|---|---|---|---|---|
| 1033718317 | Rockvegas Enterprises Inc Dba Gateway Pharmacy | Pharmacy | 524 N Gateway Ave, Rockwood, TN 37854-2353 | 2020-10-19 |
| 1609040062 | Rockwood Pharmacy, P.C. | Pharmacy | 32825 Fort Rd, Rockwood, MI 48173-1157 | 2008-04-16 |
| 1619578382 | Roc Rex LLC | Pharmacy | 32825 Fort Rd, Rockwood, MI 48173-1157 | 2020-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124626767 | Knoxville Rx Corp | Pharmacy | 10205 Kingston Pike Ste E, Knoxville, TN 37922-3285 | 2020-10-15 |
| 1073126181 | Off Center, LLC | Pharmacy | 910 Overton Plz, Livingston, TN 38570-1753 | 2020-08-28 |
| 1316557937 | Guardian Pharmacy of Tennessee Three, LLC | Pharmacy | 661 E Lane St Ste B, Shelbyville, TN 37160-3437 | 2020-08-07 |
| 1447860507 | Fph LLC | Pharmacy | 2200 N Central Ave, Humbolt, TN 38343 | 2020-08-04 |
| 1366069965 | Plaza Pharmacy LLC | Pharmacy | 3024 Covington Pike Ste 5, Memphis, TN 38128-5043 | 2020-06-30 |
| 1548886104 | Tumlin Rx, LLC | Pharmacy | 104 E Main Blvd, Church Hill, TN 37642-3724 | 2020-06-19 |
| 1366065278 | Life Well Pharmacy, LLC | Pharmacy | 2408 Susannah St Ste 3, Johnson City, TN 37601-1765 | 2020-05-27 |
| 1699398602 | Walgreen Co | Pharmacy | 262 Danny Thomas Pl Ste 100rx, Memphis, TN 38105-3678 | 2020-05-26 |
| 1053931881 | Jones & Joslin, Pllc | Pharmacy | 4249 Highway 411 Ste 5, Madisonville, TN 37354-1544 | 2020-04-22 |
| 1619596731 | Arlington Apothecary Inc | Pharmacy | 5847 Airline Rd Ste 109, Arlington, TN 38002-5132 | 2020-04-09 |
| 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.