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WALMART PHARMACY 10-1177
NPI 1306863659
Pharmacy - Community/Retail Pharmacy in Manchester, MO

Active since July 16, 2006CLIA 26D2143734 · Waiver
201 HIGHLANDS BOULEVARD DR, MANCHESTER, MO 63011(636) 256-4835 Get Directions Write a Review

NPPES record last updated: August 28, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 28, 2023, Feb 20, 2017 (2 updates tracked since 2017).

About Walmart Pharmacy 10-1177 NPPES

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

WALMART PHARMACY 10-1177 (NPI 1306863659) is a healthcare organization registered as a community/retail pharmacy in Manchester, Missouri and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through February 4, 2028 and lists Sarah Little, Director Of Healthcare Contracting, as its authorized official.

NPPES Registry Identity

NPI1306863659
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address201 HIGHLANDS BOULEVARD DRManchester, MO 63011-4383
Mailing Address702 Sw 8th StBentonville, AR 72716-0445
Phone(636) 256-4835
Organization SubpartNo
Authorized OfficialSarah LittleDirector Of Healthcare Contracting · (479) 277-2500
Enumeration DateJuly 16, 2006
Last NPPES UpdateAugust 28, 20232 updates tracked since enumeration
NPPES CertifiedAugust 28, 2023
✔ NPI 1306863659 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 MO · 2002009479
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
201 HIGHLANDS BOULEVARD DR, Manchester, MO 63011
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Other Names 1

Doing Business AsWalmart Pharmacy 10-1177

Other Identifiers 2

Medicaid602565509MO
Other2051039Pk

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 26D2143734

Walmart Pharmacy 10-1177 · Manchester, MO
Active · expires Feb 4, 2028
CLIA Number26D2143734
Laboratory TypePharmacy
Certificate Effective DateFebruary 5, 2026
Certificate Expiration DateFebruary 4, 2028
Laboratory DirectorAmy Bias
Laboratory Phone(479) 227-2374
Laboratory LocationWalmart Pharmacy 10-1177201 Highlands Bouldevard Drive, Manchester, MO 63011
CLIA data matches this NPI record on: Name
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.
228 services226 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.
222 services220 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.

AMY BIAS
Pharmacist
201 HIGHLANDS BOULEVARD DR
MANCHESTER, MO 63011
St. Louis County (314) 346-9424
WAL-MART STORES EAST, LP
Technician/Technologist (Optician)
201 HIGHLANDS BOULEVARD DR
BALLWIN, MO 63011
St. Louis County (636) 256-0697
DR. BRIAN STEFANI PHARM.D.
Pharmacist
201 HIGHLANDS BOULEVARD DR
MANCHESTER, MO 63011
St. Louis County (636) 256-4835
DR. ELDIJANA PILIPOVIC
Pharmacist
201 HIGHLANDS BOULEVARD DR
MANCHESTER, MO 63011
St. Louis County (314) 229-2780
AMY B BRUNIG O.D.
Optometrist
201 HIGHLANDS BOULEVARD DR, VISION CENTER
BALLWIN, MO 63011
St. Louis County (636) 256-3285
DR. SUSAN L CARLISLE O.D.
Optometrist
201 HIGHLANDS BOULEVARD DR
BALLWIN, MO 63011
St. Louis County (636) 256-3285

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 1306863659. It was assigned to this organization in the NPPES registry on July 16, 2006. The provider is doing business as Walmart Pharmacy 10-1177.

Where is Wal-Mart Stores East LP located?

Wal-Mart Stores East LP is located at 201 Highlands Boulevard Dr, Manchester, MO 63011. The listed phone number is (636) 256-4835.

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.

Does Wal-Mart Stores East LP hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2143734) is associated with this NPI, valid through February 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Wal-Mart Stores East LP accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 52 other insurers 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 August 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.