Wal-Mart Stores, INC

NPI #1659460525 in Ammon, Idaho

Provider Information

NPI Number: 1659460525
Entity Type: Organization
Organization Name: Wal-Mart Stores, INC
Primary Specialty: Eyewear Supplier
Enumeration Date: Oct 11, 2006
Last Updated: Sep 11, 2025

Practice Location

Address: 1201 S 25TH E
City: Ammon
State: Idaho
ZIP Code: 83406-5729
Phone: (208) 522-0204

Authorized Official

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

Specialties & Taxonomy Codes

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

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