Wal-Mart Stores, Inc.

NPI #1003999640 in Blaine, Minnesota

Provider Information

NPI Number: 1003999640
Entity Type: Organization
Organization Name: Wal-Mart Stores, Inc.
Primary Specialty: Eyewear Supplier
Enumeration Date: Oct 24, 2006
Last Updated: Sep 11, 2025

Practice Location

Address: 4405 PHEASANT RIDGE DR NE
City: Blaine
State: Minnesota
ZIP Code: 55449-4531
Phone: (763) 784-0147

Authorized Official

Name: LINDA M. EPPERSON
Title: NPI COORDINATOR
Phone: (316) 788-5580

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician/Technologist - Optician — Optician	156FX1800X
Eyewear Supplier	332H00000X	Primary

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