Wal-Mart Stores East LP

NPI #1588904593 in Panama Beach City, Florida

Provider Information

NPI Number: 1588904593
Entity Type: Organization
Organization Name: Wal-Mart Stores East LP
Subpart: Yes (part of a larger organization)
Parent Organization: WAL-MART STORES EAST LP
Primary Specialty: Eyewear Supplier
Enumeration Date: Feb 28, 2013
Last Updated: Feb 28, 2013

Practice Location

Address: 15495 PANAMA CITY BEACH PKY
City: Panama Beach City
State: Florida
ZIP Code: 32413
Phone: (850) 708-6971

Authorized Official

Name: MS. SARIAN GRIDER
Title: SPECIALIST PLAN ENROLLMENT
Phone: (479) 204-6375

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician/Technologist	156F00000X
Eyewear Supplier	332H00000X	Primary

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