Organization
SAMS WEST INC
Active
Parent organization
WAL-MART STORES INC
Other names
Sams Club Optical 30-4942
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
DIANNA PAINTER (ENROLLMENT SPECIALIST)
(479) 277-1238
Entity
Organization
Contact information
Practice address
1000 S RANDALL RD, ELGIN, IL 60123-4108
(847) 888-8197
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
07/03/2012
Last updated
07/03/2012
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