Organization
WAL-MART STORE EAST, LP
Active
Parent organization
WAL-MART STORES, INC.
Other names
Walmart Vision Center 30-6879
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC.
Authorized official
LAURA LEVINE (DIR HEALTHCARE CONTRACT & ENROLL)
(479) 204-8550
Entity
Organization
Contact information
Practice address
2820 GILLESPIE ST., FAYETTEVILLE, NC 28306
(910) 364-0311
(910) 484-9009
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8550
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
02/05/2016
Last updated
01/03/2017
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