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WALMART PHARMACY 10-5107
NPI 1780603795
Pharmacy - Community/Retail Pharmacy in Madison, TN

Active since July 19, 2006CLIA 44D2144725 · Waiver
109 GALLATIN PIKE N, MADISON, TN 37115(615) 865-6077(615) 865-6763 Get Directions Write a Review

NPPES record last updated: August 30, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 30, 2023, Feb 15, 2017, Dec 16, 2016 (3 updates tracked since 2016).

About Walmart Pharmacy 10-5107 NPPES

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

WALMART PHARMACY 10-5107 (NPI 1780603795) is a healthcare organization registered as a community/retail pharmacy in Madison, Tennessee and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through February 21, 2028 and lists Sarah Little, Director Of Healthcare Contracting, as its authorized official.

NPPES Registry Identity

NPI1780603795
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address109 GALLATIN PIKE NMadison, TN 37115-3701
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 204-8550 · Fax (479) 277-4331
Phone(615) 865-6077
Fax(615) 865-6763
Organization SubpartNo
Authorized OfficialSarah LittleDirector Of Healthcare Contracting · (479) 277-2500
Enumeration DateJuly 19, 2006
Last NPPES UpdateAugust 30, 20233 updates tracked since enumeration
NPPES CertifiedAugust 30, 2023
✔ NPI 1780603795 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 · 4189
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
109 GALLATIN PIKE N, Madison, TN 37115
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Other Names 1

Doing Business AsWalmart Pharmacy 10-5107

Other Identifiers 2

Medicaid1454978TN
Other2094719Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

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 44D2144725

Walmart Pharmacy 10-5107 · Madison, TN
Active · expires Feb 21, 2028
CLIA Number44D2144725
Laboratory TypePharmacy
Certificate Effective DateFebruary 22, 2026
Certificate Expiration DateFebruary 21, 2028
Laboratory DirectorStephanie A. Fraire
Laboratory Phone(615) 865-6077
Laboratory LocationWalmart Pharmacy 10-5107109 Gallatin Pike N, Madison, TN 37115
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
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.
25 services24 patients
Influenza vaccine split virus, preservative free 90662
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.
23 services22 patients

Medical Equipment Supplier Medicare DMEPOS 11

Medicare supplier enrollment and the product categories Wal Mart Pharmacy 10-5107 carries, from the Medicare DMEPOS supplier directory.

Wal Mart Pharmacy 10-5107

DMEPOS supplier · Madison, TNOperated by Wal-Mart Stores East, LP
⋮

Does not accept Medicare assignment

Wal Mart Pharmacy 10-5107 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20499803
Medicare Participant SinceJuly 1, 2014
Supplier Location109 Gallatin Pike NMadison, TN 37115
Phone(615) 865-6077
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 2

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

DR. UCHENNA COLLINS UDEZE PHARMD
Pharmacist
109 GALLATIN PIKE N
MADISON, TN 37115
Davidson County (615) 865-6077
JESSICA NICOLE CARTER PHARMD
Pharmacist
109 GALLATIN PIKE N
MADISON, TN 37115
Davidson County (615) 865-6077

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 East LP's NPI number?

The NPI number for Wal-Mart Stores East LP is 1780603795. It was assigned to this organization in the NPPES registry on July 19, 2006. The provider is doing business as Walmart Pharmacy 10-5107.

Where is Wal-Mart Stores East LP located?

Wal-Mart Stores East LP is located at 109 Gallatin Pike N, Madison, TN 37115. The listed phone number is (615) 865-6077.

What is Wal-Mart Stores East LP's specialty?

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

Does Wal-Mart Stores East LP accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Wal Mart Pharmacy 10-5107 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Wal-Mart Stores East LP hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2144725) is associated with this NPI, valid through February 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Wal-Mart Stores East LP accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 52 other insurers list Wal-Mart Stores East LP as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wal-Mart Stores East LP was last updated on August 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.