Organization
WAL-MART STORES EAST, LP
Active
Other names
Wal-Mart Vision Center 30-3835
Organization subpart
No
Provider details
NPI number
Authorized official
BJ RICE (PROVIDER ENROLLMENT SPECIALIST)
(479) 277-9835
Entity
Organization
Contact information
Practice address
5588 LITTLE DEBBIE PKWY, OOLTEWAH, TN 37363-4356
(423) 238-1069
Mailing address
702 SW 8TH ST., BENTONVILLE, AR 72716-0235
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
12/22/2006
Last updated
12/22/2021
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