Organization · Type 2 NPI
Wal-Mart Stores East, LP
Eyewear Supplier · Antigo, WI
NPI number
1174605083
Active
Practice location
200 State Highway 64
Antigo, WI 54409-9416
Mailing address
702 SW 8th Street
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.
Other eyewear supplier providers in Antigo
About NPI 1174605083
Wal-Mart Stores East, LP's National Provider Identifier is 1174605083, issued on Oct 19, 2006. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Antigo, WI. The record was last updated on Sep 11, 2025.