Organization · Type 2 NPI

Wal-Mart Stores East, LP

Nurse Practitioner · Columbia, SC

NPI number 1104227982 Active

Practice location

10060 Two Notch Rd
Columbia, SC 29223-4396

Call (803) 567-6338 Map

Fax (803) 736-6204

Mailing address

702 SW 8th St
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Nurse Practitioner Primary	363L00000X	None listed

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

12 other providers at this address

Other nurse practitioner providers in Columbia

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NPI record

NPI: 1104227982
Entity type: Organization (Type 2)
Issued: Sep 11, 2014
Last updated: Feb 19, 2015
Status: Active
Subpart: Yes of Wal-Mart Stores, Inc.

Other names

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Walmart Care Clinic 10-1339 · doing business as

Authorized official

Laura Levine
Director of Healthcare Contracting
(479) 204-8550

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104227982

Wal-Mart Stores East, LP's National Provider Identifier is 1104227982, issued on Sep 11, 2014. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Columbia, SC. The record was last updated on Feb 19, 2015.