Organization · Type 2 NPI
Wal-Mart Stores, Inc
Eyewear Supplier · Ponderay, ID
NPI number
1114017357
Active
Practice location
476999 Highway 95
Ponderay, ID 83852-9738
Mailing address
702 SW 8th St
Bentonville, AR 72716-0235
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.
4 other providers at this address
About NPI 1114017357
Wal-Mart Stores, Inc's National Provider Identifier is 1114017357, issued on Oct 16, 2006. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Ponderay, ID. The record was last updated on Sep 11, 2025.