WAL-MART STORES EAST LP (NPI# 1780601005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780601005 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Other Organization Name | WALMART PHARMACY 10-0065 |
| Practice Address |
350 Park Ridge Rd Sullivan MO 63080-3334 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 5734685121 |
| 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 |
2002009458 | MO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 602027401 | 05 | |
| PK | 2050473 | 01 |
| Other Name | Type Code |
|---|---|
| WALMART PHARMACY 10-0065 | 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 |
350 PARK RIDGE RD |
| City | SULLIVAN |
| State | MO |
| Zip Code | 63080-3334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871237 | Brandilynn Siess | Pharmacist | 350 Park Ridge Rd, Sullivan, MO 63080-3334 | 2020-11-02 |
| 1417557265 | Rebecca Levy | Pharmacist | 350 Park Ridge Rd, Sullivan, MO 63080-3334 | 2020-10-30 |
| 1780284638 | Gina Westermeier | Pharmacist | 350 Park Ridge Rd, Sullivan, MO 63080-3334 | 2020-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669896650 | Lindsay Nicole Arnette | Physical Therapist | 940 Mattox Drive, Meramec Nursing Center, Sullivan, MO 63080 | 2014-02-11 |
| 1407099500 | Victorian Manor of Sullivan | Assisted Living Facility | 1250 East Springfield Rd, Sullivan, MO 63080 | 2009-04-20 |
| 1578729992 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 123 Progress Parkway, Sullivan, MO 63080 | 2008-08-05 |
| 1386826089 | Sellers Family Chiropractic PC | Chiropractor | 405 Wal Mart Drive, Sullivan, MO 63080 | 2007-12-04 |
| 1740495282 | Tasha Marie Rodriguez | Physical Therapist | 107 Congress Dr., Sullivan, MO 63080 | 2007-05-10 |
| 1033261649 | Clyde William Sellers II | Chiropractor | 405 Walmart Dr., Sullivan, MO 63080 | 2007-01-17 |
| 1407954209 | Sara Skidmore | Occupational Therapist | 2022 Phoenix Drive, Sullivan, MO 63080 | 2006-09-20 |
| 1083724116 | Sharon A Titter | Physical Therapist | 107 Progress Dr, Sullivan, MO 63080 | 2006-08-30 |
| 1437135571 | Thanh Duy Vo | Pediatrics | 486 N Church St, Sullivan, MO 63080 | 2005-12-20 |
| 1508849316 | Air Evac Ems Inc | Ambulance | 673 Sappington Bridge Rd, Sullivan, MO 63080 | 2005-11-25 |
| Find all providers in zip 63080 | ||||
| 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 |
|---|---|---|---|---|
| 1720426430 | Clark's Rx Farmington, LLC | Pharmacy | 254 S Service Rd E, Sullivan, MO 63080-1367 | 2013-06-05 |
| 1932208907 | John's Pharmacy Inc | Pharmacy | 102 E Harrison St, Sullivan, IL 61951-2002 | 2006-09-22 |
| 1023111796 | Highland Park Cvs, L.L.C. | Pharmacy | 208 W. Jackson St., Sullivan, IL 61951-1454 | 2006-09-07 |
| 1003849316 | Medkin Pharmacy LLC | Pharmacy | 105 Progress Pkwy, Sullivan, MO 63080-2359 | 2006-07-09 |
| 1669724001 | Reed Pharmacies, LLC | Pharmacy | 17 N Hamilton St, Sullivan, IL 61951-1452 | 2012-10-10 |
| 1487771564 | Jtw Inc | Pharmacy | 13 W Jackson St, Sullivan, IN 47882-1503 | 2007-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374629 | Curators of The University of Missouri | Pharmacy | 7115 East St. Charles Road, Columbia, MO 65202 | 2020-10-21 |
| 1376141143 | Phillips Pharmacy, LLC | Pharmacy | 7278 State Highway 14 E, Sparta, MO 65753-9345 | 2020-10-14 |
| 1013527761 | Rpcs, Inc. | Pharmacy | 18128 State Hwy 13, Branson West, MO 65737 | 2020-08-07 |
| 1205446184 | Rpcs, Inc. | Pharmacy | 200 Southtowne Blvd, Hollister, MO 65672-9610 | 2020-08-05 |
| 1912517897 | Rpcs, Inc. | Pharmacy | 1447 State Highway 248 Ste J, Branson, MO 65616-8161 | 2020-08-05 |
| 1245849801 | Rpcs Inc | Pharmacy | 163 W Old Mill Rd, Fair Grove, MO 65648-7918 | 2020-07-29 |
| 1760005219 | Meta Pharmacy Solutions | Pharmacy | 108 Triad Ctr W, O Fallon, MO 63366-7541 | 2020-05-19 |
| 1437778172 | Harps Food Stores, Inc | Pharmacy | 707 Specialty Dr, Dexter, MO 63841-2718 | 2020-04-13 |
| 1013540038 | Auburn Pharmacy Inc | Pharmacy | 810 W 35th St Ste 101, Higginsville, MO 64037-1865 | 2020-02-18 |
| 1801428495 | Scpg Missouri LLC | Pharmacy | 501 South Madison Ave, Suite S, Webb City, MO 64870 | 2020-02-11 |
| 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.