Organization
SAM'S EAST, INC.
Active
Parent organization
WAL-MART STORES, INC.
Other names
Sam's Club Optical 30-4828
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
11920 NARCOOSSEE RD, ORLANDO, FL 32832-0000
(407) 204-8622
(407) 816-8164
Mailing address
702 SW 8TH ST, MS 0445, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
09/15/2016
Last updated
01/04/2017
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