Organization
WAL-MART STORES EAST, LP
Active
Parent organization
WAL-MART STORES, INC.
Other names
Wal-Mart Vision Center 30-3061
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC.
Authorized official
EMILY BLACKARD (ENROLLMENT SPECIALIST)
(479) 204-8705
Entity
Organization
Contact information
Practice address
7437 WATSON RD, SHREWSBURY, MO 63119-4415
(902) 755-3092
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
06/05/2015
Last updated
09/28/2015
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