# WAL-MART STORES EAST LP

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

## Provider details

- **NPI number:** 1952792145
- **Authorized official:** LAURA LEVINE (DIRECTOR OF HEALTHCARE CONTRAC)
- **Authorized official phone:** (479) 204-8550

## Contact information

- **Practice address:** 920 AVENUE G, KENTWOOD, LA 70444-2635
- **Practice address phone:** (985) 229-2905
- **Practice address fax:** (985) 229-2906
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-0445
- **Mailing address phone:** (479) 277-1240
- **Mailing address fax:** (479) 277-4331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | PHY.007073.RC | LA | Yes |

## Other

- **Enumeration date:** 02/10/2015
- **Last updated:** 07/08/2015