Wal-Mart Stores East, LP

NPI #1558752360 in Morristown, Tennessee

Provider Information

NPI Number: 1558752360
Entity Type: Organization
Organization Name: Wal-Mart Stores East, LP
Subpart: Yes (part of a larger organization)
Parent Organization: WAL-MART STORES, INC.
Primary Specialty: Eyewear Supplier
Enumeration Date: Feb 16, 2015
Last Updated: Feb 16, 2015

Practice Location

Address: 4331 W. ANDREW JOHNSON HIGHWAY
City: Morristown
State: Tennessee
ZIP Code: 37814
Phone: (423) 254-6675

Authorized Official

Name: LARUA LEVINE
Title: DIRECTOR, OF HEALTHCARE CONTRACTING
Phone: (479) 204-8550

Specialties & Taxonomy Codes

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

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