Organization · Type 2 NPI

Wal-Mart Stores East, LP

Eyewear Supplier · Sweetwater, TN

NPI number 1194164996 Active

Practice location

935 State Hwy 11 South
Sweetwater, TN 37874

Call (423) 337-7900 Map

Fax (423) 337-7902

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.

Another provider at this address

Bridgette Vestal, PharmDPharmacist Sweetwater, TN NPI 1962833913

NPI record

NPI: 1194164996
Entity type: Organization (Type 2)
Issued: Jun 14, 2013
Last updated: Jun 19, 2013
Status: Active
Subpart: Yes of Wal-Mart Stores, Inc

Other names

<unavail>
Wal-Mart Vision Center 30-4166 · doing business as

Authorized official

Laura Levine
MGR Gov Contracting
(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.

Is this your record? How to update it.

About NPI 1194164996

Wal-Mart Stores East, LP's National Provider Identifier is 1194164996, issued on Jun 14, 2013. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Sweetwater, TN. The record was last updated on Jun 19, 2013.