# 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:** WAL-MART PHARMACY 10-2682
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336166537
- **Authorized official:** SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
- **Authorized official phone:** (479) 277-2500

## Contact information

- **Practice address:** 282 BERLIN MALL RD STE 1, BERLIN, VT 05602-8493
- **Practice address phone:** (802) 229-8049
- **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 | 380003298 | VT | Yes |

## Other

- **Enumeration date:** 07/16/2006
- **Last updated:** 08/29/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 01006555 | — | VT |
| 05 | — | 1006555 | — | VT |
| 01 | — | 2101632 | PK | — |