# WAL-MART STORES EAST LP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WAL-MART PHARMACY 10-2569
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043238736
- **Authorized official:** SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
- **Authorized official phone:** (479) 277-2500

## Contact information

- **Practice address:** 461 STATE ROUTE 10, STE 29, LEDGEWOOD, NJ 07852-9510
- **Practice address phone:** (973) 252-3663
- **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 | 28RS00571500 | NJ | Yes |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 02/20/2017
