Organization
WAL-MART PUERTO RICO INC
Active
Other names
Sams Club Optical #6690, Sam's Optical Center 30-6690
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SR DIRECTOR)
(480) 853-0515
Entity
Organization
Contact information
Practice address
2180 AVE. EDUARDO RUBERTE, BO. PAMPANOS, PONCE, PR 00732
(787) 844-7524
(787) 812-1825
Mailing address
1 CUSTOMER DR, MS 0445, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
01/28/2010
Last updated
07/17/2026
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