Organization
SAM'S EAST, INC
Active
Parent organization
WAL-MART STORES, INC.
Other names
Sam's Club Vision Center 30-4109
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC.
Authorized official
LAURA LEVINE (DIR GOV CONTRACTING & ENROLLMENT)
(479) 204-8550
Entity
Organization
Contact information
Practice address
2861 BEENE BLVD, BOSSIER CITY, LA 71111-5575
(318) 606-6016
(318) 742-1969
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
06/09/2014
Last updated
06/09/2014
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