Organization
WAL-MART STORES EAST, LP
Active
Other names
Vision Center 30-1875
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J SIMMONS (NPI COORDINATOR)
(479) 277-9373
Entity
Organization
Contact information
Practice address
407 GEORGE CLAUSS BLVD, GLEN BURNIE, MD 21144-4933
(410) 969-0705
Mailing address
702 SW 8TH ST., BENTONVILLE, AR 72716-0235
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
10/18/2006
Last updated
02/27/2008
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