Organization · Type 2 NPI

Wal-Mart Stores East LP

Eyewear Supplier · Randallstown, MD

NPI number 1053661447 Active

Practice location

8730 Liberty Rd
Randallstown, MD 21133-4710

Call (443) 576-3076 Map

Mailing address

702 SW 8th St
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Optician	156FX1800X	None listed
Eyewear Supplier Primary	332H00000X	None listed

Eyewear Supplier: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

5 other providers at this address

NPI record

NPI: 1053661447
Entity type: Organization (Type 2)
Issued: Sep 13, 2012
Last updated: Sep 13, 2012
Status: Active
Subpart: Yes of Wal-Mart Stores Inc

Other names

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Wal-Mart Vision Center 30-3804 · doing business as

Authorized official

Dianna Painter
Enrollment Specialist
(479) 277-1238

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1053661447

Wal-Mart Stores East LP's National Provider Identifier is 1053661447, issued on Sep 13, 2012. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Randallstown, MD. The record was last updated on Sep 13, 2012.