Organization
WAL-MART STORES, INC.
Active
Other names
Vision Center 30-5477
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HOLLY C WILKINSON (CARRIER SPECIALIST)
(479) 204-8320
Entity
Organization
Contact information
Practice address
401 SUPERCENTER DR, JEFFERSON CITY, MO 65101-8190
(573) 635-3535
Mailing address
702 SW 8TH STREET, BENTONVILLE, AR 72716-0235
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
05/06/2009
Last updated
05/06/2009
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