Organization
WAL-MART STORES EAST, LP
Active
Other names
Wal-Mart Vision Center 30-1205
Organization subpart
No
Provider details
NPI number
Authorized official
BJ RICE (PROVIDER ENROLLMENT SPECIALIST)
(479) 277-9835
Entity
Organization
Contact information
Practice address
9218 SO. STATE ROAD 228, MACCLENNY, FL 36063
(904) 259-4760
Mailing address
702 SW 8TH ST., BENTONVILLE, AR 72716-0235
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
12/22/2006
Last updated
09/11/2025
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