Organization
WAL-MART STORES EAST, LP
Active
Parent organization
WAL-MART STORES, INC.
Other names
Walmart Vision Center 30-5964
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC.
Authorized official
LAURA LEVINE (DIR HEALTHCARE CONTRACT & ENROLL)
(479) 204-8550
Entity
Organization
Contact information
Practice address
1720 E HILLSBOROUGH AVE, TAMPA, FL 33610-8234
(479) 277-2500
Mailing address
702 SW 8TH ST, MS 0445, BENTONVILLE, AR 72716-6209
(479) 277-2500
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
03/18/2015
Last updated
03/19/2015
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