# WAL-MART STORES EAST, LP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WAL-MART STORES, INC.
- **Other names:** Walmart Pharmacy 10-2095
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1740657618
- **Legal business name:** WAL-MART STORES, INC.
- **Authorized official:** LAURA LEVINE (DIR HEALTHCARE CONTRACTING & ENROLL)
- **Authorized official phone:** (479) 204-8550

## Contact information

- **Practice address:** 15 TOBEY RD, WAREHAM, MA 02571-1083
- **Practice address phone:** (508) 295-8855
- **Practice address fax:** (508) 295-6742
- **Mailing address:** 702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-0445
- **Mailing address phone:** (479) 258-6180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/27/2015
- **Last updated:** 08/27/2015