WALMART PHARMACY 10-0647 NPI 1831116326
Pharmacy - Community/Retail Pharmacy in Grinnell, IA

Organization Pharmacy Community/Retail Pharmacy CLIA Number 16D2130640 CLIA Certificate of Waiver

About WALMART PHARMACY 10-0647

Walmart Pharmacy 10-0647 is a provider established in Grinnell, Iowa specializing in Pharmacy with a focus in community/retail pharmacy . The NPI number of Walmart Pharmacy 10-0647 is 1831116326 and was assigned on July 2006. The practitioner's primary taxonomy code is 3336C0003X with license number 1107202 (IA). The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Walmart Pharmacy 10-0647. The authorized official of this NPI record is Sarah Little (Director Of Healthcare Contracting)

NPI
1831116326
Provider NameWALMART PHARMACY 10-0647
Provider Location Address415 INDUSTRIAL AVE GRINNELL, IA 50112
Provider Mailing Address702 SW 8TH ST BENTONVILLE, AR 72716
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameWALMART PHARMACY 10-0647
Other Name TypeDoing Business As (3)
Enumeration Date07-17-2006
Last Update Date07-19-2018



The CLIA number of Walmart Pharmacy 10-0647 is 16D2130640 registered as a "pharmacy" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Walmart Pharmacy 10-0647 to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.



Primary Taxonomy

Taxonomy Code3336C0003X
ClassificationPharmacy
TypeSuppliers
SpecializationCommunity/Retail Pharmacy
License No.1107202
License StateIA
Taxonomy DescriptionA 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.

Business Address

WALMART PHARMACY 10-0647
415 INDUSTRIAL AVE
GRINNELL, IA
ZIP 50112
Phone: (641) 236-6333

Get Directions


Mailing Address

WALMART PHARMACY 10-0647
702 SW 8TH ST
BENTONVILLE, AR
ZIP 72716
Phone:


Authorized Official

Authorized Official Name SARAH LITTLE
Authorized Official TitleDIRECTOR OF HEALTHCARE CONTRACTING
Authorized Official Phone(479) 277-2500

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1831116326 is:

CLIA Number16D2130640
Facility TypePHARMACY
Certificate TypeCertificate of Waiver

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1332B00000XSuppliersDurable Medical Equipment & Medical SuppliesNo

Taxonomy Description: a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

2333600000XSuppliersPharmacyNo

Taxonomy Description: a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
0022657MEDICAID (05)IA
22657MEDICAID (05)IA
2027983OTHER (01)PK

NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1831116326
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2861211234
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 6 + 1 + 2 + 1 + 1 + 2 + 3 + 4 + 24 = 54
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 54 = 66

The NPI number 1831116326 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1184186603 ALEX RUFFCORN
Individual
Pharmacist415 INDUSTRIAL AVE
GRINNELL, IA 50112
(641) 236-6333
1740748714 PARTH G PATEL PHARMD
Individual
Pharmacist415 INDUSTRIAL AVE
GRINNELL, IA 50112
(641) 236-6333

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Walmart Pharmacy 10-0647 is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.