Organization
SAMS EAST, INC
Active
Parent organization
WAL-MART STORES, INC.
Other names
Sam's Club Optical 30-7658
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
10100 CANAL XING, BRUNSWICK, GA 31525-6705
(479) 204-8550
Mailing address
702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-0445
(479) 204-8550
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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