Organization
WAL-MART STORES EAST LP
Active
Parent organization
WAL-MART STORES EAST LP
Other names
Wal-Mart Vision Center 30-3119
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES EAST LP
Authorized official
MS. SARIAN GRIDER (SPECIALIST PLAN ENROLLMENT)
(479) 204-6375
Entity
Organization
Contact information
Practice address
15495 PANAMA CITY BEACH PKY, PANAMA BEACH CITY, FL 32413
(850) 708-6971
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-3675
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
02/28/2013
Last updated
02/28/2013
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