WALMART PHARMACY 10-4558
NPI 1154691723
Pharmacy - Community/Retail Pharmacy in Covington, GA

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

The NPI number for Wal-Mart Stores East LP is 1154691723. It was assigned to this organization in the NPPES registry on January 12, 2012. The provider is doing business as Walmart Pharmacy 10-4558.

Q: 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.

Active since January 12, 2012CLIA 11D2176692 · Waiver

4200 SALEM RD, COVINGTON, GA 30016(678) 212-3202 Get Directions Write a Review

NPPES record last updated: August 29, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 29, 2023, Feb 16, 2017, Dec 16, 2016 (3 updates tracked since 2016).

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About Walmart Pharmacy 10-4558 NPPES

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

WALMART PHARMACY 10-4558 (NPI 1154691723) is a healthcare organization registered as a community/retail pharmacy in Covington, Georgia and active in the NPI registry since January 2012. The organization holds a CLIA Waiver certificate valid through December 19, 2027 and lists Sarah Little, Director Of Healthcare Contracting, as its authorized official.

NPPES Registry Identity

NPI1154691723

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameWAL-MART STORES EAST LP

Location Address4200 SALEM RDCovington, GA 30016-4533

Mailing Address702 Sw 8th StBentonville, AR 72716-6209 · (479) 277-1238 · Fax (479) 277-4331

Phone(678) 212-3202

Organization SubpartNo

Authorized OfficialSarah LittleDirector Of Healthcare Contracting · (479) 277-2500

Enumeration DateJanuary 12, 2012

Last NPPES UpdateAugust 29, 20233 updates tracked since enumeration

NPPES CertifiedAugust 29, 2023

✔ NPI 1154691723 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in GA · PHRE009811

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

4200 SALEM RD, Covington, GA 30016

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Other Names 1

Doing Business AsWalmart Pharmacy 10-4558

Other Identifiers 2

Medicaid003133430AGA

Other2133475Pk

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 11D2176692

Walmart Pharmacy 10-4558 · Covington, GA

Active · expires Dec 19, 2027

CLIA Number11D2176692

Laboratory TypePharmacy

Certificate Effective DateDecember 20, 2025

Certificate Expiration DateDecember 19, 2027

Laboratory DirectorOyedeji Oluwakemi

Laboratory Phone(678) 212-3202

Laboratory LocationWalmart Pharmacy 10-45584200 Salem Road, Covington, GA 30016

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 2

Services this provider delivered to Medicare fee-for-service patients, from the 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.

47 services47 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.

42 services42 patients

Other Providers at the Same Location NPPES 6

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

DR TEDRICK RASHEED & ASSOCIATES PC

Optometrist