Organization · Type 2 NPI

Wal-Mart Stores East LP

Community/Retail Pharmacy · Port Orange, FL

NPI number 1922456128 Active

Practice location

3811 Clyde Morris Blvd
Port Orange, FL 32129-2306

Call (386) 281-6889 Map

Fax (386) 281-6888

Mailing address

702 SW 8th St, Mailstop 0445
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	PH30245 (FL)

Community/Retail Pharmacy: 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 …

2 other providers at this address

Other community/retail pharmacy providers in Port Orange

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NPI record

NPI: 1922456128
Entity type: Organization (Type 2)
Issued: May 27, 2016
Last updated: Aug 29, 2023
Status: Active

Other names

<unavail>
Walmart Pharmacy 10-3629 · doing business as
Walmart Pharmacy 10-3629 · doing business as

Authorized official

Sarah Little
Director of Healthcare Contracting
(479) 277-2500

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 1922456128

Wal-Mart Stores East LP's National Provider Identifier is 1922456128, issued on May 27, 2016. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Port Orange, FL. The record was last updated on Aug 29, 2023.