Organization
WAL-MART STORES EAST, LP
Active
Other names
Vision Center 30-2092
Organization subpart
No
Provider details
NPI number
Authorized official
MR. G WESLEY CRAINSHAW III (PROVIDER ENROLLMENT SPECIALIST)
(479) 277-1850
Entity
Organization
Contact information
Practice address
3000 FORD STREET EXT, OGDENSBURG, NY 13669-4480
(315) 394-7902
(315) 394-9536
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
01/09/2007
Last updated
09/11/2025
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