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WAL-MART PHARMACY 10-2680
NPI 1104843325
Pharmacy - Community/Retail Pharmacy in South Bend, IN

Active since July 16, 2006
3701 PORTAGE AVE, SOUTH BEND, IN 46628(574) 243-5849 Get Directions Write a Review

NPPES record last updated: February 16, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Wal-mart Pharmacy 10-2680 NPPES

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

WAL-MART PHARMACY 10-2680 (NPI 1104843325) is a healthcare organization registered as a community/retail pharmacy in South Bend, Indiana and active in the NPI registry since July 2006. The organization lists Sarah Little, Director Of Healthcare Contracting, as its authorized official.

NPPES Registry Identity

NPI1104843325
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address3701 PORTAGE AVESouth Bend, IN 46628-6098
Mailing Address702 Sw 8th StBentonville, AR 72716-0445
Phone(574) 243-5849
Organization SubpartNo
Authorized OfficialSarah LittleDirector Of Healthcare Contracting · (479) 277-2500
Enumeration DateJuly 16, 2006
Last NPPES UpdateFebruary 16, 2017
✔ NPI 1104843325 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 IN · 60005426A
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
3701 PORTAGE AVE, South Bend, IN 46628
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Other Names 1

Doing Business AsWal-mart Pharmacy 10-2680

Other Identifiers 4

Medicaid200220460AIN
Medicare NSC4355050486
Medicaid200220460IN
Other2024164Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Moda Health Plan, Inc..Insurance ›

Other Providers at the Same Location NPPES 3

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

JUDY A POE PHARMD
Pharmacist
3701 PORTAGE AVE
SOUTH BEND, IN 46628
St. Joseph County (574) 243-5849
EVAN BEAKAS
Pharmacist
3701 PORTAGE AVE
SOUTH BEND, IN 46628
St. Joseph County (574) 243-4915
POLLIE A WEAVER
Pharmacist
3701 PORTAGE AVE
SOUTH BEND, IN 46628
St. Joseph County (574) 243-5849

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wal-Mart Stores East LP's NPI number?

The NPI number for Wal-Mart Stores East LP is 1104843325. It was assigned to this organization in the NPPES registry on July 16, 2006. The provider is doing business as Wal-Mart Pharmacy 10-2680.

Where is Wal-Mart Stores East LP located?

Wal-Mart Stores East LP is located at 3701 Portage Ave, South Bend, IN 46628. The listed phone number is (574) 243-5849.

What is Wal-Mart Stores East LP's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

What insurance does Wal-Mart Stores East LP accept?

Health plans from Medica and Moda Health Plan, Inc. list Wal-Mart Stores East LP as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wal-Mart Stores East LP was last updated on February 16, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.