Organization · Type 2 NPI

Wal-Mart Stores East, LP

Eyewear Supplier · Shreveport, LA

NPI number 1336513993 Active

Practice location

4701 Nothport Blvd
Shreveport, LA 71107

Call (318) 929-9561 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.

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NPI record

NPI: 1336513993
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

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Walmart Vision Center 30-6932 · doing business as

Authorized official

Laura Levine
Dir Healthcare Contract&enrollmenr
(479) 204-8550

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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 1336513993

Wal-Mart Stores East, LP's National Provider Identifier is 1336513993, issued on Nov 19, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Shreveport, LA. The record was last updated on Nov 19, 2015.