Wal-Mart Stores, INC

NPI #1184711632 in Medford, Oregon

Provider Information

NPI Number
1184711632
Entity Type
Organization
Organization Name
Wal-Mart Stores, INC
Primary Specialty
Eyewear Supplier
Enumeration Date
Oct 6, 2006
Last Updated
Sep 11, 2025

Practice Location

Address
3615 CRATER LAKE HWY
State
Oregon
ZIP Code
97504-9259
Phone
(541) 770-2010

Authorized Official

Name
NICOLE D GENTILE
Title
NPI COORDINATOR
Phone
(316) 788-5580

Specialties & Taxonomy Codes

Specialty
Technician/Technologist - OpticianOptician
Eyewear Supplier

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