Organization
WAL-MART STORES EAST, LP
Active
Parent organization
WAL-MART STORES, INC.
Other names
Wal-Mart Vision Center 30-2946
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC.
Authorized official
LAURA LEVINE (DIR HEALTHCARE CONTRACTING & ENROLL)
(479) 204-8550
Entity
Organization
Contact information
Practice address
2500 W BROWARD BLVD, FORT LAUDERDALE, FL 33312-1300
(479) 277-1240
Mailing address
702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-0445
(479) 258-6180
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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