Organization
WAL-MART STORES INC
Active
Other names
Wal-Mart Vision Center 30-2069
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNA PAINTER (ENROLLMENT SPECIALIST)
(479) 277-1238
Entity
Organization
Contact information
Practice address
1360 CENTER DR, MEDFORD, OR 97501
(541) 535-9170
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
06/25/2012
Last updated
06/25/2012
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