1. Home
  2. Directory
  3. Oregon
  4. Bend
  5. Pharmacy
  6. NPI Profile

WAL-MART PHARMACY 10-2075
NPI 1639411937
Pharmacy - Community/Retail Pharmacy in Bend, OR

Active since March 25, 2013CLIA 38D2332581 · Waiver
20120 PINEBROOK BLVD, BEND, OR 97702(541) 389-5440(541) 389-5382 Get Directions Write a Review

NPPES record last updated: March 25, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Wal-mart Pharmacy 10-2075 NPPES

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

WAL-MART PHARMACY 10-2075 (NPI 1639411937) is a healthcare organization registered as a community/retail pharmacy in Bend, Oregon and active in the NPI registry since March 2013. The organization holds a CLIA Waiver certificate valid through October 20, 2027 and lists Deb Lauver, Specialist Plan Enrollment, as its authorized official.

NPPES Registry Identity

NPI1639411937
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES, INC.
Location Address20120 PINEBROOK BLVDBend, OR 97702-2537
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 204-8741
Phone(541) 389-5440
Fax(541) 389-5382
Organization SubpartNo
Authorized OfficialDeb LauverSpecialist Plan Enrollment · (479) 204-8741
Enumeration DateMarch 25, 2013
✔ NPI 1639411937 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
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
20120 PINEBROOK BLVD, Bend, OR 97702
Open in Google Maps ↗

Other Names 1

Doing Business AsWal-mart Pharmacy 10-2075

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 38D2332581

Walmart Pharmacy 10-2075 · Bend, OR
Active · expires Oct 20, 2027
CLIA Number38D2332581
Laboratory TypePharmacy
Certificate Effective DateOctober 21, 2025
Certificate Expiration DateOctober 20, 2027
Laboratory DirectorSusie A. Jones
Laboratory Phone(541) 389-5440
Laboratory LocationWalmart Pharmacy 10-207520120 Pinebrook Blvd, Bend, OR 97702
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 12

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

EYES IN MOTION
Optometrist
20120 PINEBROOK BLVD
BEND, OR 97702
Deschutes County (541) 389-2508
TEDD MARCEAU
Pharmacist
20120 PINEBROOK BLVD
BEND, OR 97702
Deschutes County (541) 389-5440
WAL-MART STORES, INC.
Eyewear Supplier
20120 PINEBROOK BLVD
BEND, OR 97702
Deschutes County (541) 317-9385
MRS. SUSIE ANN JONES RPH
Pharmacist
20120 PINEBROOK BLVD
BEND, OR 97702
Deschutes County (541) 389-5440
SUSIE NOSLER
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
20120 PINEBROOK BLVD
BEND, OR 97702
Deschutes County (541) 389-5440
NATIONAL VISION, INC.
Eyewear Supplier
20120 PINEBROOK BLVD
BEND, OR 97702
Deschutes County (541) 317-9382
GOULDING EYECARE LLC
Optometrist
20120 PINEBROOK BLVD
BEND, OR 97702
Deschutes County (541) 389-2508
KEITH DAUGHERTY RPH
Pharmacist
20120 PINEBROOK BLVD
BEND, OR 97702
Deschutes County (541) 389-5440

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, Inc.'s NPI number?

The NPI number for Wal-Mart Stores, Inc. is 1639411937. It was assigned to this organization in the NPPES registry on March 25, 2013. The provider is doing business as Wal-Mart Pharmacy 10-2075.

Where is Wal-Mart Stores, Inc. located?

Wal-Mart Stores, Inc. is located at 20120 Pinebrook Blvd, Bend, OR 97702. The listed phone number is (541) 389-5440.

What is Wal-Mart Stores, Inc.'s specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Wal-Mart Stores, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2332581) is associated with this NPI, valid through October 20, 2027. 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 Stores, Inc. was last updated on March 25, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.