Organization · Type 2 NPI

Wal-Mart Stores East, LP

Eyewear Supplier · Horn Lake, MS

NPI number 1184098733 Active

Practice location

4150 Goodman Road West
Horn Lake, MS 38637

Call (662) 253-6179 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.

NPI record

NPI: 1184098733
Entity type: Organization (Type 2)
Issued: Nov 19, 2015
Last updated: Nov 19, 2015
Status: Active
Subpart: Yes of Wal-Mart Stores, Inc.

Other names

<unavail>
Walmart Vision Center 30-6964 · doing business as

Authorized official

Laura Levine
Dir Healthcare Contract & Enrollmne
(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 1184098733

Wal-Mart Stores East, LP's National Provider Identifier is 1184098733, issued on Nov 19, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Horn Lake, MS. The record was last updated on Nov 19, 2015.