Organization
WAL-MART STORES, INC
Active
Other names
Wal-Mart Vision Center 30-4101
Organization subpart
No
Provider details
NPI number
Authorized official
DEB LAUVER (SPECIALIST PLAN ENROLLMENT)
(479) 258-2115
Entity
Organization
Contact information
Practice address
3705 E SOUTH ST, LONG BEACH, CA 90805-4521
(562) 582-1133
(562) 582-9049
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
10/31/2014
Last updated
04/14/2015
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