Wal-Mart Stores, Inc.

NPI #1356455315 in Benton, Illinois

Provider Information

NPI Number
1356455315
Entity Type
Organization
Organization Name
Wal-Mart Stores, Inc.
Primary Specialty
Eyewear Supplier
Enumeration Date
Aug 18, 2006
Last Updated
Sep 11, 2025

Practice Location

Address
919 GIACONE DR
City
Benton
ZIP Code
62812-1639
Phone
(618) 439-9453

Authorized Official

Name
TAMMY J BOYD
Title
CONTRACT COORDINATOR
Phone
(479) 277-1359

Specialties & Taxonomy Codes

Specialty
Technician/Technologist - OpticianOptician
Eyewear Supplier

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