Organization
WAL-MART PUERTO RICO INC
Active
Other names
Walmart Vision Center 30-5803, Walmart SC 5803
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SR DIRECTOR)
(480) 853-0515
Entity
Organization
Contact information
Practice address
PR-2 TODD AVE. CORCHADO ST. CORNER, SAN JUAN, PR 00936
(787) 641-5600
Mailing address
1 CUSTOMER DR, MS 0445, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
12/26/2012
Last updated
07/17/2026
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