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Wal-mart Stores East Lp
Community/Retail Pharmacy in South Bend, Indiana
NPI 1104843325

Wal-mart Stores East Lp is a Community/Retail Pharmacy based in Bentonville, IN and is specialized in Community/Retail Pharmacy. Wal-mart Stores East Lp practices in South Bend, IN. The NPI Number for Wal-mart Stores East Lp is 1104843325 and holds a License No. (Indiana).

The current practice location address for Wal-mart Stores East Lp is 3701 Portage Ave, South Bend, IN and can be reached out via phone at 574-243-5849.

Location: 3701 Portage Ave, South Bend, IN, 72716-0445
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104843325
Provider Name
Wal-mart Stores East Lp
Credential
Provider Entity Type
Organization
Address
3701 Portage Ave, South Bend, IN, 72716-0445
Phone Number
574-243-5849
Fax Number
Provider Enumeration Date
07/16/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2024164 01 PK
200220460 05 IN
200220460A 05 IN
institution
Provider Business Practice Location Address Details
Address
3701 Portage Ave
City
South Bend
State
Indiana
Zip
46628-6098
Phone Number
574-243-5849
Fax Number
person
Provider Business Mailing Address Details
Address
3701 Portage Ave
City
South Bend
State
Indiana
Zip
46628-6098
Phone Number
574-243-5849
Fax Number
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
60005426A (Indiana)
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Pharmacy
Speciality
-
Taxonomy
333600000X
License No.
()
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
person
Provider's Taxonomy Details 3
Type
Suppliers
Classification
Pharmacy
Speciality
Community/Retail Pharmacy
Taxonomy
3336C0003X
License No.
()
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.
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