WAL-MART PHARMACY 10-2548 - NPI 1164449492 - Pharmacy in South Williamson, KY

Q: What is the provider's specialty?

The provider's specialty is Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

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About Wal-mart Pharmacy 10-2548 NPPES

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

WAL-MART PHARMACY 10-2548 (NPI 1164449492) is a healthcare organization registered as a community/retail pharmacy in South Williamson, Kentucky and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through May 22, 2027 and lists Sarah Little, Director Of Healthcare Contracting, as its authorized official.

NPPES Registry Identity

NPI1164449492

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameWAL-MART STORES EAST LP

Location Address28402 US HIGHWAY 119South Williamson, KY 41503-3924

Mailing Address702 Sw 8th StBentonville, AR 72716-0445

Phone(606) 237-4443

Organization SubpartNo

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

Enumeration DateJuly 16, 2006

Last NPPES UpdateAugust 23, 20233 updates tracked since enumeration

NPPES CertifiedAugust 23, 2023

✔ NPI 1164449492 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 KY · P06585

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

28402 US HIGHWAY 119, South Williamson, KY 41503

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Other Names 1

Doing Business AsWal-mart Pharmacy 10-2548

Other Identifiers 3

Other2033407Pk

Medicaid5400180500KY

Medicaid5400701800KY

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 18D2131127

Walmart Pharmacy 10-2548 · South Williamson, KY

Active · expires May 22, 2027

CLIA Number18D2131127

Laboratory TypePharmacy

Certificate Effective DateMay 23, 2025

Certificate Expiration DateMay 22, 2027

Laboratory DirectorMr. Joshua D. Bostic

Laboratory Phone(606) 237-4443

Laboratory LocationWalmart Pharmacy 10-254828402 Us Highway 119 N, South Williamson, KY 41503

CLIA data matches this NPI record on: Address 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.

123 services121 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.

109 services107 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.

14 services14 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.

11 services11 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.

JASON DWIGHT NEAL PHARM D

Pharmacist