Organization · Type 2 NPI

Wal-Mart Store East, LP

Eyewear Supplier · Fayetteville, NC

NPI number 1720446776 Active

Practice location

2820 Gillespie St.
Fayetteville, NC 28306

Call (910) 364-0311 Map

Fax (910) 484-9009

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.

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NPI record

NPI: 1720446776
Entity type: Organization (Type 2)
Issued: Feb 5, 2016
Last updated: Jan 3, 2017
Status: Active
Subpart: Yes of Wal-Mart Stores, Inc.

Other names

<unavail>
Walmart Vision Center 30-6879 · doing business as

Authorized official

Laura Levine
Dir Healthcare Contract & Enroll
(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 1720446776

Wal-Mart Store East, LP's National Provider Identifier is 1720446776, issued on Feb 5, 2016. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Fayetteville, NC. The record was last updated on Jan 3, 2017.