Organization
WAL-MART STORES EAST, LP
Active
Other names
Vision Center 30-3731
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J. SIMMONS (NPI ASSOCIATE)
(479) 277-9373
Entity
Organization
Contact information
Practice address
460 NM HIGHWAY #528, BERNALILLO, NM 87004
(505) 771-4883
Mailing address
702 SW 8TH ST., BENTONVILLE, AR 72716-0235
(479) 277-9373
(479) 277-8176
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
02/25/2008
Last updated
02/25/2008
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