Walmart Sc #5793

NPI #1265560320 in Coto Laurel, Puerto Rico

Provider Information

NPI Number: 1265560320
Entity Type: Organization
Organization Name: Walmart Sc #5793
Primary Specialty: Eyewear Supplier
Enumeration Date: Mar 1, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 333 STATE RD 14
City: Coto Laurel
State: Puerto Rico
ZIP Code: 00780-0000
Phone: (787) 651-0448

Authorized Official

Name: MR. JORGE L HERNANDEZ
Title: DIR OF SPECIALTY DIVISIONS
Phone: (787) 653-7777

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X	Primary

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