Wal-Mart Stores, Inc.

NPI #1619053808 in Logan, Utah

Provider Information

NPI Number
1619053808
Entity Type
Organization
Organization Name
Wal-Mart Stores, Inc.
Primary Specialty
Eyewear Supplier
Enumeration Date
Oct 31, 2006
Last Updated
Sep 11, 2025

Practice Location

Address
1550 N MAIN ST
City
Logan
State
Utah
ZIP Code
84341-1918
Phone
(435) 753-0880

Authorized Official

Name
NICOLE D GENTILE
Title
NPI COORDINATOR
Phone
(316) 788-5580

Specialties & Taxonomy Codes

Specialty
Technician/Technologist - OpticianOptician
Eyewear Supplier

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