WALMART PHARMACY 10-5054
NPI 1811916893
Pharmacy - Community/Retail Pharmacy in Jacksonville, FL

Active since July 19, 2006CLIA 10D2178735 · Waiver
11900 ATLANTIC BLVD, JACKSONVILLE, FL 32225(904) 641-7551 Get Directions Write a Review

NPPES record last updated: August 30, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 30, 2023, May 11, 2023, Feb 16, 2017 and 1 more (4 updates tracked since 2016).

About Walmart Pharmacy 10-5054 NPPES

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

WALMART PHARMACY 10-5054 (NPI 1811916893) is a healthcare organization registered as a community/retail pharmacy in Jacksonville, Florida and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through February 6, 2028 and lists Sarah Little, Director Of Healthcare Contracting, as its authorized official.

NPPES Registry Identity

NPI1811916893
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address11900 ATLANTIC BLVDJacksonville, FL 32225-2920
Mailing Address702 Sw 8th StBentonville, AR 72716-0445
Organization SubpartNo
Authorized OfficialSarah LittleDirector Of Healthcare Contracting · (479) 277-2500
Enumeration DateJuly 19, 2006
Last NPPES UpdateAugust 30, 20234 updates tracked since enumeration
NPPES CertifiedAugust 30, 2023
NPI 1811916893 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License Licensed in FL · PH18953
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
Also ListedPharmacy · Specialty PharmacyTaxonomy 3336S0011X
11900 ATLANTIC BLVD, Jacksonville, FL 32225

Other Names 1

Doing Business AsWalmart Pharmacy 10-5054

Other Identifiers 3

Medicaid025860100FL
Other2015178Pk
Medicaid25860100FL

Accepted 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 10D2178735

Wal-Mart Stores East LP · Jacksonville, FL
Active · expires Feb 6, 2028
CLIA Number10D2178735
Laboratory TypePharmacy
Certificate Effective DateFebruary 7, 2026
Certificate Expiration DateFebruary 6, 2028
Laboratory DirectorNadia Shams
Laboratory Phone(904) 641-7551
Laboratory LocationWal-Mart Stores East LP11900 Atlantic Blvd Attention Walmart Pharmacy 10-5054, Jacksonville, FL 32225
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 3

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 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.
75 services74 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.
72 services71 patients
Administration of pneumococcal vaccine G0009
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.
14 services14 patients

Other Providers at the Same Location NPPES 11

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

Chiropractor
11900 ATLANTIC BLVD, SUITE 226
JACKSONVILLE, FL 32225
Optometrist
11900 ATLANTIC BLVD
JACKSONVILLE, FL 32225
Chiropractor
11900 ATLANTIC BLVD, SUITE 226
JACKSONVILLE, FL 32225
Optometrist
11900 ATLANTIC BLVD
JACKSONVILLE, FL 32225
Chiropractor
11900 ATLANTIC BLVD, STE 226
JACKSONVILLE, FL 32225
Pharmacist
11900 ATLANTIC BLVD
JACKSONVILLE, FL 32225
Pharmacist
11900 ATLANTIC BLVD
JACKSONVILLE, FL 32225
Chiropractor
11900 ATLANTIC BLVD
JACKSONVILLE, FL 32225

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1811916893, enumerated as an "organization" on July 19, 2006.

The provider is located at 11900 ATLANTIC BLVD JACKSONVILLE, FL 32225 and the phone number is (904) 641-7551.

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.