Wal-mart Stores East Lp, NPI 1063439131
Community/Retail Pharmacy in Beaver Dam, WI, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1063439131
NPI Entity Type Organization
Provider Name Wal-mart Stores East Lp
Doing Business As
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Provider Location Address 120 Frances Ln, Beaver Dam, WI, US
Provider Mailing Address 702 Sw 8th St, Bentonville, AR, US, 727160445
Is Sole Proprietor? No
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Organization Official

Official Name Sarah Little
Official Position DIRECTOR OF HEALTHCARE CONTRACTING
Phone 479-277-2500

Primary Taxonomy

Taxonomy Code

3336C0003X

Taxonomy Name Community/Retail Pharmacy
Classification

Pharmacy

Group

Suppliers

License No. 8417-42
License State WI
Description 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.

Other Organization Name

Walmart Pharmacy 10-1012
Doing Business As

Business Address

Wal-mart Stores East Lp
120 Frances Ln

Beaver Dam, WI, US

Phone: 920-885-5808
Fax: 920-885-5908

Mailing Address

Wal-mart Stores East Lp
702 Sw 8th St
Bentonville, AR, US
ZIP 727160445
Phone: 479-204-8550
Fax: 479-277-4331

Secondary Taxonomies

Taxonomy Code Group Classification License No. State Primary?

332B00000X

Suppliers

Durable Medical Equipment & Medical Supplies

No

333600000X

Suppliers

Pharmacy

No

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
2110165 PK 01
33276900 WI MEDICAID 05

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Fort Healthcare, Inc

Organization

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