Organization
WAL-MART STORES EAST LP
Active
Parent organization
WAL-MART STORES INC
Other names
Vision Center 30-2560
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
LISA FROMM (ENROLLMENT SPECIALIST)
(479) 204-8550
Entity
Organization
Contact information
Practice address
11416 OCEAN GTWY, BERLIN, MD 21811-2549
(410) 629-0502
Mailing address
702 SW 8TH STREET, BENTONVILLE, AR 72716-0235
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
02/10/2012
Last updated
02/10/2012
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