Organization
WALMART INC.
Active
Other names
Walmart Vision Center 30-1199
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR)
(480) 853-0515
Entity
Organization
Contact information
Practice address
171 YODER AVENUE, AVON, CO 81620
(970) 949-6442
Mailing address
702 SW 8TH STREET, BENTONVILLE, AR 72716-0235
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
10/24/2006
Last updated
07/14/2025
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