Organization
WAL-MART STORES EAST LP
Active
Parent organization
WAL-MART STORES INC
Other names
Wal-Mart Vision Center 30-2987
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
MS. SARIAN GRIDER (SPECIALIST PLAN ENROLLMENT)
(479) 204-6375
Entity
Organization
Contact information
Practice address
4301 S UNIVERSITY DR, DAVIE, FL 33328
(954) 331-3612
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6029
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
03/06/2013
Last updated
03/06/2013
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