Organization
WAL-MART STORES EAST, LP
Active
Parent organization
WAL-MART STORES, INC
Other names
Walmart Vision Center 30-1566
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC
Authorized official
KYLEE FISHER (MANAGER)
(479) 204-1258
Entity
Organization
Contact information
Practice address
4024 ELKHART RD STE 2, GOSHEN, IN 46526-5801
(479) 204-1258
(479) 277-4331
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
04/25/2017
Last updated
04/25/2017
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