Wal-Mart Stores, INC
NPI #1649351685 in Bonney Lake, Washington
Provider Information
- NPI Number
- 1649351685
- Entity Type
- Organization
- Organization Name
- Wal-Mart Stores, INC
- Primary Specialty
- Eyewear Supplier
- Enumeration Date
- Oct 18, 2006
- Last Updated
- Sep 11, 2025
Practice Location
- Address
- 19205 STATE ROUTE 410 E
- City
- Bonney Lake
- State
- Washington
- ZIP Code
- 98391-6305
- Phone
- (253) 826-9144
Authorized Official
- Name
- NICOLE D GENTILE
- Title
- NPI COORDINATOR
- Phone
- (316) 788-5580
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician/Technologist - Optician — Optician |
| Eyewear Supplier |
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