WALMART PHARMACY 10-1190
NPI 1356368674
Pharmacy - Community/Retail Pharmacy in Berea, KY

Active since July 16, 2006CLIA 18D2143184 · Waiver

NPPES record last updated: August 28, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 28, 2023, Feb 16, 2017 (2 updates tracked since 2017).

About Walmart Pharmacy 10-1190 NPPES

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

WALMART PHARMACY 10-1190 (NPI 1356368674) is a healthcare organization registered as a community/retail pharmacy in Berea, Kentucky and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through January 24, 2028 and lists Sarah Little, Director Of Healthcare Contracting, as its authorized official.

NPPES Registry Identity

NPI1356368674
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address120 JILL DRBerea, KY 40403-1677
Mailing Address702 Sw 8th StBentonville, AR 72716-0445
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 1356368674 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 · PO2478
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
120 JILL DR, Berea, KY 40403

Other Names 1

Doing Business AsWalmart Pharmacy 10-1190

Other Identifiers 3

Medicaid5402826100KY
Medicaid5400740600KY
Other2031791Pk

Accepted 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 18D2143184

Wal-Mart Stores East, LP Dba Wal-Mart Pharmacy #10-1190 · Berea, KY
Active · expires Jan 24, 2028
CLIA Number18D2143184
Laboratory TypePharmacy
Certificate Effective DateJanuary 25, 2026
Certificate Expiration DateJanuary 24, 2028
Laboratory DirectorMs. Casey Colbert
Laboratory Phone(479) 277-1039
Laboratory LocationWal-Mart Stores East, LP Dba Wal-Mart Pharmacy #10-1190120 Jill Dr, Berea, KY 40403
CLIA data matches this NPI record on: Address 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.
91 services91 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.
86 services86 patients

Other Providers at the Same Location NPPES 13

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

Optometrist (Corneal and Contact Management)
120 JILL DR
BEREA, KY 40403
Pharmacist
120 JILL DR
BEREA, KY 40403
Pharmacist
120 JILL DR
BEREA, KY 40403
Pharmacist
120 JILL DR
BEREA, KY 40403
Pharmacist
120 JILL DR
BEREA, KY 40403
Optometrist
120 JILL DR
BEREA, KY 40403
Pharmacist
120 JILL DR
BEREA, KY 40403
Nurse Practitioner (Family)
120 JILL DR
BEREA, KY 40403

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 1356368674. It was assigned to this organization in the NPPES registry on July 16, 2006. The provider is doing business as Walmart Pharmacy 10-1190.

Where is Wal-Mart Stores East LP located?

Wal-Mart Stores East LP is located at 120 Jill Dr, Berea, KY 40403. The listed phone number is (859) 986-3113.

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 18D2143184) is associated with this NPI, valid through January 24, 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 49 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 with the weekly NPPES data releases published by CMS.