WAL-MART PHARMACY 10-1301
NPI 1962420711
Pharmacy - Community/Retail Pharmacy in Roanoke, VA

Active since July 18, 2006CLIA 49D2145379 · Waiver
5350 CLEARBROOK VILLAGE LN, ROANOKE, VA 24014(540) 772-7193 Get Directions Write a Review

NPPES record last updated: August 29, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 29, 2023, Feb 15, 2017, Dec 21, 2016 (3 updates tracked since 2016).

About Wal-mart Pharmacy 10-1301 NPPES

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

WAL-MART PHARMACY 10-1301 (NPI 1962420711) is a healthcare organization registered as a community/retail pharmacy in Roanoke, Virginia and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through March 5, 2028 and lists Sarah Little, Director Of Healthcare Contracting, as its authorized official.

NPPES Registry Identity

NPI1962420711
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES EAST LP
Location Address5350 CLEARBROOK VILLAGE LNRoanoke, VA 24014-6606
Mailing Address702 Sw 8th StBentonville, AR 72716-0445
Organization SubpartNo
Authorized OfficialSarah LittleDirector Of Healthcare Contracting · (479) 277-2500
Enumeration DateJuly 18, 2006
Last NPPES UpdateAugust 29, 20233 updates tracked since enumeration
NPPES CertifiedAugust 29, 2023
NPI 1962420711 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 VA · 0201002696
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
5350 CLEARBROOK VILLAGE LN, Roanoke, VA 24014

Other Names 1

Doing Business AsWal-mart Pharmacy 10-1301

Other Identifiers 3

Medicaid008532401VA
Other2104931Pk
Medicaid8532401VA

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 49D2145379

Walmart Pharmacy 10-1301 · Roanoke, VA
Active · expires Mar 5, 2028
CLIA Number49D2145379
Laboratory TypePharmacy
Certificate Effective DateMarch 6, 2026
Certificate Expiration DateMarch 5, 2028
Laboratory DirectorDonna Witmer
Laboratory Phone(540) 772-7193
Laboratory LocationWalmart Pharmacy 10-13015350 Clearbrook Village Ln, Roanoke, VA 24014
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

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.
325 services320 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.
310 services307 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.
29 services29 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
27 services27 patients

Other Providers at the Same Location NPPES 4

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

Pharmacist
5350 CLEARBROOK VILLAGE LN
ROANOKE, VA 24014
Technician/Technologist (Optician)
5350 CLEARBROOK VILLAGE LN
ROANOKE, VA 24014
Pharmacist
5350 CLEARBROOK VILLAGE LN
ROANOKE, VA 24014
Pharmacist
5350 CLEARBROOK VILLAGE LN
ROANOKE, VA 24014

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 1962420711. It was assigned to this organization in the NPPES registry on July 18, 2006. The provider is doing business as Wal-Mart Pharmacy 10-1301.

Where is Wal-Mart Stores East LP located?

Wal-Mart Stores East LP is located at 5350 Clearbrook Village Ln, Roanoke, VA 24014. The listed phone number is (540) 772-7193.

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 hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2145379) is associated with this NPI, valid through March 5, 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 49 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 29, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.