WALMART PHARMACY 10-4639 (WALMART INC.) NPI 1427285345

Pharmacy (Community/Retail Pharmacy) in Elizabeth, CO

NPI 1427285345 Organization Pharmacy Community/Retail Pharmacy Medicare Supplier Does Not Accept Medicare Approved Payment CLIA Number 06D2155970 CLIA Certificate of Waiver

About WALMART PHARMACY 10-4639 (WALMART INC.)

Walmart Pharmacy 10-4639 (walmart Inc.) is a provider established in Elizabeth, Colorado specializing in pharmacy (community/retail pharmacy) . The NPI number of Walmart Pharmacy 10-4639 (walmart Inc.) is 1427285345 and was assigned on June 2009. The practitioner's primary taxonomy code is 3336C0003X with license number 773 (CO). The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as Walmart Pharmacy 10-4639. The authorized official of this NPI record is Sarah Little (Director Of Healthcare Contracting)

Walmart Pharmacy 10-4639 is a medicare supplier with PTAN 0279613377 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Oral Antiemetic Drugs or Epoetin or Blood Glucose Monitors/Supplies (Mail Order) or Infusion Drugs or Enteral Nutrients or Nebulizer Drugs or Surgical Dressings or Immunosuppressive Drugs or Ostomy Supplies or Oral Anticancer Drugs or Blood Glucose Monitors/Supplies (Non-Mail Order).

The CLIA number of Walmart Pharmacy 10-4639 is 06D2155970 registered as a "pharmacy" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Walmart Pharmacy 10-4639 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.

NPI

1427285345

Provider NameWALMART PHARMACY 10-4639 (WALMART INC.)
Provider Location Address2100 LEGACY CIR ELIZABETH, CO 80107
Provider Mailing Address702 SW 8TH ST BENTONVILLE, AR 72716
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameWALMART PHARMACY 10-4639
Other Name TypeDoing Business As (3)
Enumeration Date06-18-2009
Last Update Date07-19-2018


Primary Taxonomy

Taxonomy Code3336C0003X
ClassificationPharmacy
TypeSuppliers
SpecializationCommunity/Retail Pharmacy
License No.773
License StateCO
Taxonomy DescriptionA 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.

Business Address

WALMART PHARMACY 10-4639
2100 LEGACY CIR
ELIZABETH, CO
ZIP 80107
Phone: (303) 646-2289

Get Directions


Mailing Address

WALMART PHARMACY 10-4639
702 SW 8TH ST
BENTONVILLE, AR
ZIP 72716
Phone: (479) 277-1238
Fax: (479) 277-4331



Authorized Official

Authorized Official Name SARAH LITTLE
Authorized Official TitleDIRECTOR OF HEALTHCARE CONTRACTING
Authorized Official Phone(479) 277-2500

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN0279613377
Accepts Medicare AssignmentNO
Specialities ListPharmacy.
Supplies List
  • Oral Antiemetic Drugs - FDA antiemetic drugs
  • Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
  • 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
  • Infusion Drugs -
  • Enteral Nutrients - Enteral formula
  • Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
  • Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
  • Oral Anticancer Drugs - FDA anticancer 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
Competitive BiddingNO

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 the NPI number 1427285345 is:

CLIA Number06D2155970
Facility TypePHARMACY
Certificate TypeCertificate of Waiver

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1332B00000XSuppliersDurable Medical Equipment & Medical SuppliesNo

Taxonomy Description: a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
64100286MEDICAID (05)CO
2120758OTHER (01)

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1982267571 BROOKE BURNS PHARMD
Individual
Pharmacist2100 LEGACY CIR
ELIZABETH, CO 80107
(303) 646-2289

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.