Wal-Mart Stores INC

NPI #1205260148 in Medford, Oregon

Provider Information

NPI Number: 1205260148
Entity Type: Organization
Organization Name: Wal-Mart Stores INC
Subpart: Yes (part of a larger organization)
Parent Organization: WAL-MART STORES INC
Primary Specialty: Eyewear Supplier
Enumeration Date: Aug 28, 2013
Last Updated: Aug 28, 2013

Practice Location

Address: 3615 CRATER LAKE HWY
City: Medford
State: Oregon
ZIP Code: 97504-9259
Phone: (541) 772-3451

Authorized Official

Name: MRS. LAURA LEVINE
Title: MANAGER OF GOVERMENT CONTRACTS
Phone: (479) 204-8550

Specialties & Taxonomy Codes

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

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