# WAL-MART STORES EAST LP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WalMart Pharmacy 10-5669
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265773923
- **Authorized official:** SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
- **Authorized official phone:** (479) 277-2500

## Contact information

- **Practice address:** 4140 W GREENFIELD AVE, WEST MILWAUKEE, WI 53215-1334
- **Practice address phone:** (414) 978-2007
- **Practice address fax:** (414) 978-2008
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-0445
- **Mailing address phone:** (479) 204-8741
- **Mailing address fax:** (479) 277-4331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 9187-42 | WI | Yes |

## Other

- **Enumeration date:** 03/06/2013
- **Last updated:** 08/30/2023