Organization
WAL-MART PUERTO RICO, INC.
Active
Other names
Sam's Optical Center 30-4866
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTH CAR CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
PR-2 KM 2.2 KENNEDY AVE, SAN JUAN, PR 00936
(787) 522-3601
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-1258
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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