Organization · Type 2 NPI

Wal-Mart Stores East, LP

Eyewear Supplier · North Augusta, GA

NPI number 1205244274 Active

Practice location

1041 Edgefield
North Augusta, GA 29860

Call (479) 277-2500 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: 1205244274
Entity type: Organization (Type 2)
Issued: Jul 23, 2014
Last updated: Jul 23, 2014
Status: Active
Subpart: Yes of Wal-Mart Stores, Inc.

Other names

<unavail>
Walmart Vision Center 30-6576 · doing business as

Authorized official

Laura Levine
Dir Healthcare Contracting & 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 1205244274

Wal-Mart Stores East, LP's National Provider Identifier is 1205244274, issued on Jul 23, 2014. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in North Augusta, GA. The record was last updated on Jul 23, 2014.