Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Vision Center 30-4269
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (DIRECTOR OF HEALTH CARE CONTRACTING)
(480) 853-0515
Entity
Organization
Contact information
Practice address
9700 OCEAN HIGHWAY WEST, CALABASH, NC 28467
(910) 393-4043
(910) 393-4049
Mailing address
1 CUSTOMER DR, BENTONVILLE, AR 72716-0445
(405) 202-9925
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
07/13/2026
Last updated
07/14/2026
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