Wal-Mart Stores East, LP

NPI #1205917044 in Hannibal, Missouri

Provider Information

NPI Number: 1205917044
Entity Type: Organization
Organization Name: Wal-Mart Stores East, LP
Primary Specialty: Eyewear Supplier
Enumeration Date: Oct 18, 2006
Last Updated: Sep 11, 2025

Practice Location

Address: 3650 STARDUST DR
City: Hannibal
State: Missouri
ZIP Code: 63401-2480
Phone: (573) 221-5610

Authorized Official

Name: NICOLE D GENTILE
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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