Organization · Type 2 NPI

Wal-Mart Stores East, LP

Eyewear Supplier · Columbia, SC

NPI number 1104274307 Active

Practice location

733 Fashion Drive
Columbia, SC 29229-0000

Call (803) 223-0778 Map

Mailing address

702 SW 8th St, Mailstop 0445
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.

Another provider at this address

Jacob Shell, PharmDPharmacist Columbia, SC NPI 1790135416

Other eyewear supplier providers in Columbia

See all in Columbia →

NPI record

NPI: 1104274307
Entity type: Organization (Type 2)
Issued: May 27, 2016
Last updated: May 27, 2016
Status: Active
Subpart: Yes of Wal-Mart Stores, Inc.

Other names

<unavail>
Sams Club Optical Center 30-4872 · doing business as

Authorized official

Laura Levine
Dir Healthcare Contract & Enroll
(479) 204-8550

Verify this record

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 1104274307

Wal-Mart Stores East, LP's National Provider Identifier is 1104274307, issued on May 27, 2016. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Columbia, SC. The record was last updated on May 27, 2016.