# WAL-MART STORES EAST, LP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WAL-MART STORES, INC.
- **Other names:** Sams Club Optical Center 30-4872
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1104274307
- **Legal business name:** WAL-MART STORES, INC.
- **Authorized official:** LAURA LEVINE (DIR HEALTHCARE CONTRACT & ENROLL)
- **Authorized official phone:** (479) 204-8550

## Contact information

- **Practice address:** 733 FASHION DRIVE, COLUMBIA, SC 29229-0000
- **Practice address phone:** (803) 223-0778
- **Mailing address:** 702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-0445
- **Mailing address phone:** (479) 204-8550
- **Mailing address fax:** (479) 277-4331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 156FX1800X | Optician | — | NULL | — |
| 156FX1800X | Optician | — | — | — |
| 332H00000X | Eyewear Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 05/27/2016
- **Last updated:** 05/27/2016