# WAL-MART STORES EAST LP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Walmart Pharmacy 10-3839
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053702860
- **Authorized official:** LAURA LEVINE (DIRECTOR OF HEALTHCARE CONTRAC)
- **Authorized official phone:** (479) 204-8550

## Contact information

- **Practice address:** 9181 HIGHWAY 67, CLINTON, LA 70722-4919
- **Practice address phone:** (256) 828-0029
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-0445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | PHY.007107-RC | LA | Yes |

## Other

- **Enumeration date:** 02/16/2015
- **Last updated:** 08/04/2015