Organization
WAL-MART STORES EAST, LP
Active
Other names
Vision Center 30-1173
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE D GENTILE (NPI COORDINATOR)
(904) 642-4999
Entity
Organization
Contact information
Practice address
8808 BEACH BLVD, JACKSONVILLE, FL 32216-4621
(904) 642-4999
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
10/11/2006
Last updated
09/11/2025
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