Organization
WAL-MART STORES, INC.
Active
Other names
Walmart Vision Center 30-1395
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEVINE (DIR. HEALTHCARE CONTRACT&ENROLLMENT)
(479) 204-8550
Entity
Organization
Contact information
Practice address
1212 W MCCORD ST, CENTRALIA, IL 62801-5648
(479) 204-8705
Mailing address
702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
04/25/2016
Last updated
04/25/2016
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