Organization
WAL-MART STORES EAST, L.P
Active
Other names
Vision Center 30-1644
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J. SIMMONS (NPI ASSOCIATE)
(479) 277-9373
Entity
Organization
Contact information
Practice address
120 AJK BLVD, LEWISBURG, PA 17837-7491
(570) 522-8224
Mailing address
702 SW 8TH STREET, BENTONVILLE, AR 72716-0235
(479) 277-9373
(479) 277-8176
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
03/08/2007
Last updated
05/07/2008
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