Organization
WAL-MART PUERTO RICO INC
Active
Parent organization
WAL-MART STORES INC
Other names
Vision Center 30-2067
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
DIANNA PAINTER (ENROLLMENT SPECIALIST)
(479) 277-1238
Entity
Organization
Contact information
Practice address
975 AVE HOSTOS, STE 2100, MAYAGUEZ, PR 00680
(787) 265-1090
Mailing address
702 SW 8TH ST., BENTONVILLE, AR 72716
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
11/23/2010
Last updated
11/23/2010
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