Wal Mart Stores, INC
NPI #1265616122 in Bentonville, Arkansas
Provider Information
- NPI Number
- 1265616122
- Entity Type
- Organization
- Organization Name
- Wal Mart Stores, INC
- Primary Specialty
- Technician/Technologist - Optician
- Enumeration Date
- Dec 27, 2007
- Last Updated
- Dec 27, 2007
Practice Location
- Address
- 702 SW 8TH STREET
- City
- Bentonville
- State
- Arkansas
- ZIP Code
- 72716-0235
- Phone
- (479) 277-1850
Authorized Official
- Name
- MR. WES G CRAINSHAW III
- Title
- OPTICAL PROVIDER ENROLLMENT
- Phone
- (479) 277-1850
Specialties & Taxonomy Codes
| Specialty |
|---|
| Eyewear Supplier |
| Technician/Technologist - Optician — Optician |
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