Organization
WAL-MART STORES EAST LP
Active
Parent organization
WAL-MART STORES INC
Other names
Wal-Mart Vision Center 30-3804
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
DIANNA PAINTER (ENROLLMENT SPECIALIST)
(479) 277-1238
Entity
Organization
Contact information
Practice address
8730 LIBERTY RD, RANDALLSTOWN, MD 21133-4710
(443) 576-3076
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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