Organization
WAL-MART STORE EAST LP
Active
Parent organization
WAL-MART STORES INC
Other names
Wal-Mart Vision Center 30-2509
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
DIANNA J. PAINTER (ENROLLMENT SPECIALIST)
(479) 277-1238
Entity
Organization
Contact information
Practice address
810 SOUTH IRISH ROAD, CHILTON, WI 53014
(920) 849-8467
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
03/08/2007
Last updated
07/25/2011
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