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WALMART PHARMACY 10-5104
NPI 1023035227
Pharmacy - Community/Retail Pharmacy in Moraine, OH

Active since July 16, 2006CLIA 36D2157806 · Waiver
1701 W DOROTHY LN, MORAINE, OH 45439(937) 643-2481 Get Directions Write a Review

NPPES record last updated: August 30, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 30, 2023, Feb 20, 2017, Dec 16, 2016 (3 updates tracked since 2016).

About Walmart Pharmacy 10-5104 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALMART PHARMACY 10-5104 (NPI 1023035227) is a healthcare organization registered as a community/retail pharmacy in Moraine, Ohio and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through November 13, 2026 and lists Sarah Little, Director Of Healthcare Contracting, as its authorized official.

NPPES Registry Identity

NPI1023035227
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address1701 W DOROTHY LNMoraine, OH 45439-1838
Mailing Address702 Sw 8th StBentonville, AR 72716-0445
Phone(937) 643-2481
Organization SubpartNo
Authorized OfficialSarah LittleDirector Of Healthcare Contracting · (479) 277-2500
Enumeration DateJuly 16, 2006
Last NPPES UpdateAugust 30, 20233 updates tracked since enumeration
NPPES CertifiedAugust 30, 2023
✔ NPI 1023035227 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in OH · 021386150
Definition

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.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
1701 W DOROTHY LN, Moraine, OH 45439
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Other Names 1

Doing Business AsWalmart Pharmacy 10-5104

Other Identifiers 2

Other2078997Pk
Medicaid2421936OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2157806

Walmart Pharmacy #10-5104 · Moraine, OH
Active · expires Nov 13, 2026
CLIA Number36D2157806
Laboratory TypePharmacy
Certificate Effective DateNovember 14, 2024
Certificate Expiration DateNovember 13, 2026
Laboratory DirectorAlia Shaban
Laboratory Phone(937) 643-2481
Laboratory LocationWalmart Pharmacy #10-51041701 W Dorothy Lane, Moraine, OH 45439
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
71 services70 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
66 services66 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
13 services13 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
12 services12 patients

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EILAF SHERMADOU RPH, PHARMD
Pharmacist
1701 W DOROTHY LN
MORAINE, OH 45439
Montgomery County (937) 643-2481
MR. GREGORY SHELDON PACLEB
Technician/Technologist (Optician)
1701 W DOROTHY LN
MORAINE, OH 45439
Montgomery County (937) 643-2707
WAL-MART STORES EAST, LP
Eyewear Supplier
1701 W DOROTHY LN
KETTERING, OH 45439
Montgomery County (937) 643-2124
TAYLOR CUSUMANO
Pharmacist
1701 W DOROTHY LN
MORAINE, OH 45439
Montgomery County (937) 643-2481

Frequently Asked Questions

What is WAL-MART STORES EAST LP's NPI number?

The NPI number assigned to this healthcare provider is 1023035227, enumerated as an "organization" on July 16, 2006.

Where is the provider located?

The provider is located at 1701 W DOROTHY LN MORAINE, OH 45439 and the phone number is (937) 643-2481.

What is the provider's specialty?

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

What insurance does WAL-MART STORES EAST LP accept?

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.