Organization
WAL-MART PUERTO RICO INC
Active
Other names
Sams Club Optical 30-6689, Sam's Optical Center 30-6689
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SR DIRECTOR)
(480) 853-0515
Entity
Organization
Contact information
Practice address
PLAZA CENTRO II, AVE MUNOZ MARIN, CAGUAS, PR 00725
(787) 746-1039
(787) 746-1664
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
12/02/2010
Last updated
07/17/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up