# WAL-MART STORES EAST LP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WAL-MART STORES INC
- **Other names:** WAL-MART PHARMACY 10-3496
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1164449237
- **Legal business name:** WAL-MART STORES INC
- **Authorized official:** LAURA LEVINE (MGR OF GOVERNMENT CONTRACTING)
- **Authorized official phone:** (479) 204-8550

## Contact information

- **Practice address:** 5825 W HOPE AVE, MILWAUKEE, WI 53216-1275
- **Practice address phone:** (414) 445-3959
- **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 | 8219042 | WI | Yes |

## Other

- **Enumeration date:** 07/16/2006
- **Last updated:** 07/10/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2109993 | PK | — |
| 05 | — | 33263000 | — | WI |