Organization · Type 2 NPI

Wal-Mart Stores East, LP

Eyewear Supplier · Lake Wylie, SC

NPI number 1922479559 Active

Practice location

175 Highway 274
Lake Wylie, SC 29710-6045

Call (479) 204-8550 Map

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.

9 other providers at this address

NPI record

NPI: 1922479559
Entity type: Organization (Type 2)
Issued: Oct 8, 2015
Last updated: Oct 8, 2015
Status: Active
Subpart: Yes of Wal-Mart Stores, Inc.

Other names

<unavail>
Walmart Vision Center 30-5745 · doing business as

Authorized official

Laura Levine
Director of Contract & 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 1922479559

Wal-Mart Stores East, LP's National Provider Identifier is 1922479559, issued on Oct 8, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Lake Wylie, SC. The record was last updated on Oct 8, 2015.