Organization
WAL-MART STORES EAST, LP
Active
Other names
Vision Center 30-1711
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J SIMMONS (NPI COORDINATOR)
(479) 277-9373
Entity
Organization
Contact information
Practice address
1600 MONTCLAIR RD, BRIMINGHAM, AL 35210
(205) 956-0416
Mailing address
702 SW 8TH ST., BENTONVILLE, AR 72716-0235
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
10/19/2006
Last updated
11/07/2007
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