Organization
WALMART INC
Active
Other names
Walmart Vision Center 30-5938
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, BILLING)
(480) 853-0515
Entity
Organization
Contact information
Practice address
575 SATURN BLVD, SAN DIEGO, CA 92154-4731
(619) 205-6145
(619) 205-6149
Mailing address
1 CUSTOMER DR, BENTONVILLE, AR 72716-0445
(619) 205-6145
(619) 205-6149
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
06/24/2026
Last updated
06/25/2026
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