Wal-Mart Pharmacy 10-2680
LBN: Wal-Mart Stores East Lp
Wal-Mart Pharmacy 10-2680 is an health care organization with primary practice located at 3701 Portage Ave , South Bend IN 46628-6098. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Wal-Mart Stores East Lp can be contacted via phone (574) 243-5849, or through Little, Sarah via phone (479) 277-2500.
Contact Information
Primary practice address
3701 Portage Ave
South Bend IN 46628-6098
Phone: (574) 243-5849
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 60005426A | Indiana |
Profile Details
| NPI number | 1104843325 |
|---|---|
| LBN Legal business name | Wal-Mart Stores East Lp |
| DBA Doing business as | Wal-Mart Pharmacy 10-2680 |
| Authorized official | Little, Sarah |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 16th, 2006 |
| Last updated | Feb 16th, 2017 - about 7 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104843325 | NPPES |
| Other | 2024164 | PK | |
| MEDICAID | 200220460 | PK | |
| MEDICAID | 200220460A | PK |
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