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Wal-mart Stores East Lp
Community/Retail Pharmacy in Jefferson City, Tennessee
NPI 1760409940

Wal-mart Stores East Lp is a Community/Retail Pharmacy based in Bentonville, TN and is specialized in Community/Retail Pharmacy. Wal-mart Stores East Lp practices in Jefferson City, TN. The NPI Number for Wal-mart Stores East Lp is 1760409940 and holds a License No. (Tennessee).

The current practice location address for Wal-mart Stores East Lp is 630 E Broadway Blvd, Jefferson City, TN and can be reached out via phone at 865-475-3736 and via fax at 865-475-3954.

Location: 630 E Broadway Blvd, Jefferson City, TN, 72716-0445
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1760409940
Provider Name
Wal-mart Stores East Lp
Credential
Provider Entity Type
Organization
Address
630 E Broadway Blvd, Jefferson City, TN, 72716-0445
Phone Number
865-475-3736
Fax Number
865-475-3954
Provider Enumeration Date
07/16/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2091090 01 PK
1454056 05 TN
institution
Provider Business Practice Location Address Details
Address
630 E Broadway Blvd
City
Jefferson City
State
Tennessee
Zip
37760-4900
Phone Number
865-475-3736
Fax Number
865-475-3954
person
Provider Business Mailing Address Details
Address
630 E Broadway Blvd
City
Jefferson City
State
Tennessee
Zip
37760-4900
Phone Number
865-475-3736
Fax Number
865-475-3954
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
C2243 (Tennessee)
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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