Organization
SAM'S WEST, INC
Active
Parent organization
WAL-MART STORES, INC
Other names
Sam's Club Vision Center 30-6616
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC
Authorized official
DEB LAUVER (SPECIALIST PLAN ENROLLMENT)
(479) 258-2115
Entity
Organization
Contact information
Practice address
601 S PLACENTIA AVE, FULLERTON, CA 92831
(478) 258-2115
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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