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Organization
WAL-MART STORES EAST, LP
Active
Organization
WAL-MART STORES EAST, LP
Active
Parent organization
WAL-MART STORES, INC.
Other names
Wal-Mart Vision Center 30-4440
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC.
Authorized official
LAURA LEVINE (DIR HEALTHCARE CONTRACT & ENROLL)
(479) 204-8550
Entity
Organization
Contact information
Practice address
1180 DUTCH FORK RD, IRMO, SC 29063-8874
(803) 781-7877
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
NULL
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
NULL
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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