Organization
WAL-MART STORES EAST, LP
Active
Parent organization
WAL-MART STORES, INC.
Other names
Walmart Vision Center 30-1176
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC.
Authorized official
KIMBERLY CANONIC (SR. DIRECTOR)
(480) 853-0515
Entity
Organization
Contact information
Practice address
2600 STATE HWY 138, STOUGHTON, WI 53589-3701
(608) 501-6101
(608) 877-0428
Mailing address
1 CUSTOMER DR, MS 0445, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
12/21/2016
Last updated
04/27/2026
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