WALMART PHARMACY 10-5744 (WAL-MART STORES EAST LP) NPI 1093186629

Pharmacy (Community/Retail Pharmacy) in Theodore, AL

NPI 1093186629 Organization Pharmacy Community/Retail Pharmacy Medicare Supplier Does Not Accept Medicare Approved Payment CLIA Number 01D2160201 CLIA Certificate of Waiver

About WALMART PHARMACY 10-5744 (WAL-MART STORES EAST LP)

Walmart Pharmacy 10-5744 (wal-mart Stores East Lp) is a provider established in Theodore, Alabama specializing in pharmacy (community/retail pharmacy) . The NPI number of Walmart Pharmacy 10-5744 (wal-mart Stores East Lp) is 1093186629 and was assigned on October 2015. The practitioner's primary taxonomy code is 3336C0003X with license number 114582 (AL). The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Walmart Pharmacy 10-5744. The authorized official of this NPI record is Sarah Little (Director Of Healthcare Contracting)

Walmart Pharmacy 10-5744 is a medicare supplier with PTAN 4355052870 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Oral Anticancer Drugs or Oral Antiemetic Drugs or Blood Glucose Monitors/Supplies (Non-Mail Order) or Blood Glucose Monitors/Supplies (Mail Order) or Epoetin or Enteral Nutrients or Nebulizer Drugs or Surgical Dressings or Immunosuppressive Drugs or Ostomy Supplies or Infusion Drugs.

The CLIA number of Walmart Pharmacy 10-5744 is 01D2160201 registered as a "pharmacy" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Walmart Pharmacy 10-5744 to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1093186629

Provider NameWALMART PHARMACY 10-5744 (WAL-MART STORES EAST LP)
Provider Location Address7320 THEODORE DAWES RD THEODORE, AL 36582
Provider Mailing Address702 SW 8TH ST MAILSTOP 0445 BENTONVILLE, AR 72716
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameWALMART PHARMACY 10-5744
Other Name TypeDoing Business As (3)
Enumeration Date10-08-2015
Last Update Date02-16-2017


Primary Taxonomy

Taxonomy Code3336C0003X
ClassificationPharmacy
TypeSuppliers
SpecializationCommunity/Retail Pharmacy
License No.114582
License StateAL
Taxonomy DescriptionA 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.

Business Address

WALMART PHARMACY 10-5744
7320 THEODORE DAWES RD
THEODORE, AL
ZIP 36582
Phone: (251) 370-1721
Fax: (251) 370-1725

Get Directions


Mailing Address

WALMART PHARMACY 10-5744
702 SW 8TH ST
MAILSTOP 0445
BENTONVILLE, AR
ZIP 72716
Phone: (479) 204-8550
Fax: (479) 277-4331



Authorized Official

Authorized Official Name SARAH LITTLE
Authorized Official TitleDIRECTOR OF HEALTHCARE CONTRACTING
Authorized Official Phone(479) 277-2500

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN4355052870
Accepts Medicare AssignmentNO
Specialities ListPharmacy.
Supplies List
  • Oral Anticancer Drugs - FDA anticancer drugs
  • Oral Antiemetic Drugs - FDA antiemetic drugs
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Blood Glucose Monitors/Supplies (Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
  • Enteral Nutrients - Enteral formula
  • Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
  • Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
  • Infusion Drugs -
Competitive BiddingNO

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1093186629 is:

CLIA Number01D2160201
Facility TypePHARMACY
Certificate TypeCertificate of Waiver

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1332B00000XSuppliersDurable Medical Equipment & Medical SuppliesNo

Taxonomy Description: a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

2333600000XSuppliersPharmacyNo

Taxonomy Description: a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
4355052870MEDICARE NSC (07)
1093186629MEDICAID (05)AL
2155211OTHER (01)

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1710467568 ANGELA ELIZABETH MCFARLAND PHARMACIST
Individual
Pharmacist7320 THEODORE DAWES RD
THEODORE, AL 36582
(251) 370-1721

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.