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Organization
WAL-MART STORES EAST, LP
Active
Organization
WAL-MART STORES EAST, LP
Active
Other names
Walmart Vision Center 30-1130
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (DIRECTOR OF HEALTH CARE CONTRACTING)
(480) 853-0515
Entity
Organization
Contact information
Practice address
922 E MAIN ST, LAURENS, SC 29360-3616
(864) 682-8111
Mailing address
1 CUSTOMER DR # MS 0445, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
NULL
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
NULL
Other
Enumeration date
06/22/2026
Last updated
06/22/2026
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