Organization
WAL-MART STORES INC
Active
Other names
Wal-Mart Vision Center 30-1377
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNA PAINTER (ENROLLMENT SPECIALIST)
(479) 277-1238
Entity
Organization
Contact information
Practice address
3801 RUNNING BROOK FARMS BLVD, JOHNSBURG, IL 60050
(815) 344-8727
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
10/17/2006
Last updated
12/06/2011
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