WAL-MART PHARMACY 10-2890 - NPI 1184641425

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 10-2890 NPPES

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

WAL-MART PHARMACY 10-2890 (NPI 1184641425) is a healthcare organization registered as a community/retail pharmacy in Macon, Georgia and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through November 17, 2027 and lists Matthew Mcmullin, Director, as its authorized official.

NPPES Registry Identity

NPI1184641425

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameWAL-MART STORES EAST , LP

Location Address5955 ZEBULON RDMacon, GA 31210-2030

Mailing Address702 Sw 8th StBentonville, AR 72716-0445

Phone(478) 471-9122

Organization SubpartNo

Authorized OfficialMatthew McmullinDirector · (479) 371-8711

Enumeration DateJuly 16, 2006

Last NPPES UpdateJune 3, 20244 updates tracked since enumeration

NPPES CertifiedJune 3, 2024

✔ NPI 1184641425 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 GA · PHRE008801

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

5955 ZEBULON RD, Macon, GA 31210

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Other Names 1

Doing Business AsWal-mart Pharmacy 10-2890

Other Identifiers 2

Other2015540Pk

Medicaid00940541KGA

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 2

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 11D2175219

Walmart Pharmacy 10-2890 · Macon, GA

Active · expires Nov 17, 2027

CLIA Number11D2175219

Laboratory TypePharmacy

Certificate Effective DateNovember 18, 2025

Certificate Expiration DateNovember 17, 2027

Laboratory DirectorJasmine Graper

Laboratory Phone(478) 471-9122

Laboratory LocationWalmart Pharmacy 10-28905955 Zebulon Road, Macon, GA 31210

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2175976

Walmart Pharmacy 10-1153 · Macon, GA

Active · expires Dec 4, 2027

CLIA Number11D2175976

Laboratory TypePharmacy

Certificate Effective DateDecember 5, 2025

Certificate Expiration DateDecember 4, 2027

Laboratory DirectorAdelaide Opokuagyemang

Laboratory Phone(478) 788-8008

Laboratory LocationWalmart Pharmacy 10-11536020 Harrison Road, Macon, GA 31206

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

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.

138 services135 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.

133 services130 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.

29 services29 patients

Other Providers at the Same Location NPPES 9

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

DR. SEBORAH WILLIAMS KING O.D.

Optometrist

5955 ZEBULON RD, WAL-MART VISION CENTER
MACON, GA 31210

Bibb County (478) 477-9011

SEBORAH W. KING, O.D. & ASSOCIATES, L.L.C.

Optometrist

5955 ZEBULON RD, WALMART VISION CENTER
MACON, GA 31210

Bibb County (478) 471-9011

VBDC OF MACON LLC

Dentist (General Practice)