# WAL-MART STORES EAST LP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WAL-MART PHARMACY 10-2613
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013934215
- **Authorized official:** SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
- **Authorized official phone:** (479) 277-2500

## Contact information

- **Practice address:** 1875 E MANSFIELD ST, BUCYRUS, OH 44820-2075
- **Practice address phone:** (419) 562-8411
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-0445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 021041500 | OH | Yes |

## Other

- **Enumeration date:** 07/16/2006
- **Last updated:** 08/28/2023