WALMART - NPI 1699211300 - Pharmacy in Roanoke Rapids, NC

Q: What is the provider's specialty?

The provider's specialty is Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

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About Walmart NPPES

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

WALMART (NPI 1699211300) is a healthcare organization registered as a community/retail pharmacy in Roanoke Rapids, North Carolina and active in the NPI registry since January 2017. The organization lists Amber Haislip Daniel, Pharmacist, as its authorized official.

NPPES Registry Identity

NPI1699211300

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameWALMART

Location Address251 PREMIER BLVDRoanoke Rapids, NC 27870-5076

Mailing Address251 Premier BlvdRoanoke Rapids, NC 27870-5076

Phone(252) 535-1170

Organization SubpartNo

Authorized OfficialAmber Haislip DanielPharmacist · (252) 535-1170

Enumeration DateJanuary 19, 2017

✔ NPI 1699211300 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in NC · 24306

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.

251 PREMIER BLVD, Roanoke Rapids, NC 27870

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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 34D2139265

Walmart Pharmacy 10-1502 · Roanoke Rapids, NC

Expired · Oct 31, 2025

CLIA Number34D2139265

Laboratory TypePharmacy

Certificate Effective DateNovember 1, 2023

Certificate Expiration DateOctober 31, 2025

Laboratory DirectorNettie W. Edwards

Laboratory Phone(252) 535-1170

Laboratory LocationWalmart Pharmacy 10-1502251 Premier Boulevard, Roanoke Rapids, NC 27870

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

NETTIE WHEELER EDWARDS

Pharmacist