Organization
WAL-MART STORES, INC
Active
Other names
Wal-Mart Vision Center 30-2385
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA D PAINTER (ENROLLMENT COORDINATOR)
(479) 277-1238
Entity
Organization
Contact information
Practice address
762 OUTLET COLLECTION DR SW, AUBURN, WA 98001-6582
(253) 804-3264
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
10/13/2006
Last updated
12/28/2021
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