Organization
WAL-MART STORES EAST, LP
Active
Other names
Vision Center 30-1478
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY J BOYD (CONTRACT COORDINATOR)
(479) 277-1359
Entity
Organization
Contact information
Practice address
354 PRIVATE DRIVE 288, SOUTH POINT, OH 45680-7900
(740) 894-4023
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
08/09/2006
Last updated
05/23/2024
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