WALMART PHARMACY 10-0677
NPI 1548287741
Pharmacy - Community/Retail Pharmacy in Dyersburg, TN

Active since July 16, 2006CLIA 44D2140112 · Waiver
2650 LAKE RD, DYERSBURG, TN 38024(731) 286-6700(731) 286-6564 Get Directions Write a Review

NPPES record last updated: August 23, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 23, 2023, Feb 16, 2017 (2 updates tracked since 2017).

About Walmart Pharmacy 10-0677 NPPES

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

WALMART PHARMACY 10-0677 (NPI 1548287741) is a healthcare organization registered as a community/retail pharmacy in Dyersburg, Tennessee and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through November 13, 2027 and lists Sarah Little, Director Of Healthcare Contracting, as its authorized official.

NPPES Registry Identity

NPI1548287741
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address2650 LAKE RDDyersburg, TN 38024-1656
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 204-8550 · Fax (479) 277-4331
Fax(731) 286-6564
Organization SubpartNo
Authorized OfficialSarah LittleDirector Of Healthcare Contracting · (479) 277-2500
Enumeration DateJuly 16, 2006
Last NPPES UpdateAugust 23, 20232 updates tracked since enumeration
NPPES CertifiedAugust 23, 2023
NPI 1548287741 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 TN · C1647
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
2650 LAKE RD, Dyersburg, TN 38024

Other Names 1

Doing Business AsWalmart Pharmacy 10-0677

Other Identifiers 2

Medicaid1454042TN
Other2092301Pk

Accepted Insurance

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of influenza virus vaccine

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.

This service was performed 171 times for 168 patients

Administration of pneumococcal vaccine

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.

This service was performed 22 times for 22 patients

Influenza vaccine split virus, preservative free

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.

This service was performed 164 times for 161 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

This service was performed 15 times for 15 patients

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
44D2140112
Facility Type
Pharmacy
Certificate Effective Date
November 14, 2025
Certificate Expiration Date
November 13, 2027
Laboratory Director
JESSICA PUCKETT
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Walmart Pharmacy 10-0677 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.

Reviews for WALMART PHARMACY 10-0677

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Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Pharmacist
2650 LAKE RD
DYERSBURG, TN 38024
Pharmacist
2650 LAKE RD
DYERSBURG, TN 38024
Pharmacist
2650 LAKE RD
DYERSBURG, TN 38024
Pharmacist
2650 LAKE RD
DYERSBURG, TN 38024
Eyewear Supplier
2650 LAKE RD
DYERSBURG, TN 38024

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1548287741, enumerated as an "organization" on July 16, 2006.

The provider is located at 2650 LAKE RD DYERSBURG, TN 38024 and the phone number is (731) 286-6700.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.