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WAL-MART PHARMACY
NPI 1619378759
Pharmacist in Page, AZ

Active since September 09, 2014CLIA 03D2157989 · Waiver
1017 WEST HAUL, PAGE, AZ 86040(928) 645-2917 Get Directions Write a Review

NPPES record last updated: September 9, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wal-mart Pharmacy NPPES

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

WAL-MART PHARMACY (NPI 1619378759) is a healthcare organization registered as a pharmacist in Page, Arizona and active in the NPI registry since September 2014. The organization holds a CLIA Waiver certificate valid through November 18, 2026 and lists Stacy Lynn Smith, Pharmacist, as its authorized official.

NPPES Registry Identity

NPI1619378759
Entity TypeOrganization
Primary Taxonomy183500000X
Legal Business NameWAL-MART PHARMACY
Location Address1017 WEST HAULPage, AZ 86040-0656
Mailing Address1017 W Haul RdPage, AZ 86040 · (928) 645-2917 · Fax (928) 645-0225
Phone(928) 645-2917
Organization SubpartNo
Authorized OfficialStacy Lynn SmithPharmacist · (928) 645-2917
Enumeration DateSeptember 9, 2014
✔ NPI 1619378759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License✔ Licensed in AZ · S016867
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
1017 WEST HAUL, Page, AZ 86040
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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 SINGLE SPECIALTY GROUP

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 03D2157989

Walmart Pharmacy 10-1442 · Page, AZ
Active · expires Nov 18, 2026
CLIA Number03D2157989
Laboratory TypePharmacy
Certificate Effective DateNovember 19, 2024
Certificate Expiration DateNovember 18, 2026
Laboratory DirectorRonald Wright
Laboratory Phone(928) 645-2917
Laboratory LocationWalmart Pharmacy 10-14421017 West Haul Road, Page, AZ 86040
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Pharmacy's NPI number?

The NPI number for Wal-Mart Pharmacy is 1619378759. It was assigned to this organization in the NPPES registry on September 9, 2014.

Where is Wal-Mart Pharmacy located?

Wal-Mart Pharmacy is located at 1017 West Haul, Page, AZ 86040. The listed phone number is (928) 645-2917.

What is Wal-Mart Pharmacy's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

Does Wal-Mart Pharmacy hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2157989) is associated with this NPI, valid through November 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wal-Mart Pharmacy was last updated on September 9, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.