Organization
WAL-MART STORES EAST, LP
Active
Other names
Vision Center 30-2506
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY J BOYD (CONTRACT COORDINATOR)
(479) 277-1359
Entity
Organization
Contact information
Practice address
2600 STATE ROUTE 59, RAVENNA, OH 44266-1646
(330) 677-0338
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0235
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
08/16/2006
Last updated
09/11/2025
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