Organization
WAL-MART STORES EAST, LP
Active
Other names
Vision Center 30-2528
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE D GENTILE (NPI COORDINATOR)
(316) 788-5580
Entity
Organization
Contact information
Practice address
167 HOGAN BLVD, MILL HALL, PA 17751-1902
(570) 893-4627
Mailing address
702 SW 8TH ST., BENTONVILLE, AR 72716-0235
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
10/19/2006
Last updated
09/11/2025
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