Organization
WALMART INC.
Active
Other names
Walmart Vision Center 30-3129
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR)
(479) 371-1168
Entity
Organization
Contact information
Practice address
14100 LIMONITE AVE, EASTVALE, CA 92880-3855
(909) 563-2593
(909) 563-2582
Mailing address
1 CUSTOMER DR, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
10/08/2025
Last updated
10/08/2025
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