Organization
SAM'S WEST, INC.
Active
Parent organization
WAL-MART STORES, INC
Other names
Sam's Club Vision Center 30-4749
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC
Authorized official
LAURA LEVINE (DIR. HEALTHCARE CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
1250 SOUTH AMITY RD, CONWAY, AR 72032
(501) 205-7454
(501) 504-2576
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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