WAL-MART PHARMACY 30-3044
NPI 1285978692
Eyewear Supplier in Fort Worth, TX

Active since November 26, 2012CLIA 45D2125487 · Waiver
2900 RENAISSANCE SQUARE, FORT WORTH, TX 76105(817) 900-1912 Get Directions Write a Review

NPPES record last updated: November 26, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Wal-mart Pharmacy 30-3044 NPPES

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

WAL-MART PHARMACY 30-3044 (NPI 1285978692) is a healthcare organization registered as an eyewear supplier in Fort Worth, Texas and active in the NPI registry since November 2012. The organization holds a CLIA Waiver certificate valid through February 7, 2027 and lists Amy Powers, Specialist, Plan Enrollment, as its authorized official.

NPPES Registry Identity

NPI1285978692
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameWAL-MART STORES TEXAS LLC
Location Address2900 RENAISSANCE SQUAREFort Worth, TX 76105
Mailing Address702 Sw 8th StBentonville, AR 72716-0445
Organization SubpartYesParent: Wal-mart Stores Inc
Authorized OfficialAmy PowersSpecialist, Plan Enrollment · (479) 204-0709
Enumeration DateNovember 26, 2012
NPI 1285978692 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Also ListedTechnician/Technologist · OpticianTaxonomy 156FX1800X
2900 RENAISSANCE SQUARE, Fort Worth, TX 76105

Other Names 1

Doing Business AsWal-mart Pharmacy 30-3044

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20610365
Accepts Medicare Assignment
NO
Specialities List
Pharmacy, Optician.
Competitive Bidding
NO

Supplies List

  • Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
  • Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
  • Infusion Drugs -
  • Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
  • 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
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
  • Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
  • Enteral Nutrients - Enteral formula
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape

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 this NPI number is:

CLIA Number
45D2125487
Facility Type
Pharmacy
Certificate Effective Date
February 08, 2025
Certificate Expiration Date
February 07, 2027
Laboratory Director
DANIELLE N. HAMPTON
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Wal-mart Pharmacy 30-3044 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.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1285978692, enumerated as an "organization" on November 26, 2012.

The provider is located at 2900 RENAISSANCE SQUARE FORT WORTH, TX 76105 and the phone number is (817) 900-1912.

Eyewear Supplier with taxonomy code 332H00000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Louisiana. Please consult your insurance carrier or call the provider to verify.