# WAL-MART STORES EAST LP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Walmart Pharmacy 10-5125
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164894598
- **Authorized official:** SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
- **Authorized official phone:** (479) 277-2500

## Contact information

- **Practice address:** 2310 S UNION ST, OPELOUSAS, LA 70570-5734
- **Practice address phone:** (337) 594-6031
- **Mailing address:** 702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-0445
- **Mailing address phone:** (479) 204-8705
- **Mailing address fax:** (479) 277-4331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHY.007226-RC | LA | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/26/2015
- **Last updated:** 09/07/2023