# 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
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932200912
- **Authorized official:** RANDY WRIGHT (PHY ENROLLMENT SPECIALIST)
- **Authorized official phone:** (479) 273-6574

## Contact information

- **Practice address:** 3255 LA HIGHWAY 1 S, PORT ALLEN, LA 70767-5858
- **Practice address phone:** (225) 749-7454
- **Practice address fax:** (225) 749-7418
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-6209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 4788RC | LA | Yes |

## Other

- **Enumeration date:** 09/25/2006
- **Last updated:** 07/03/2008