Wal-Mart Stores East, LP

NPI #1700256286 in Fort Myers Beach, Florida

Provider Information

NPI Number: 1700256286
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: Sep 28, 2015
Last Updated: Sep 28, 2015

Practice Location

Address: 17105 SAN CARLOS BLVD
City: Fort Myers Beach
State: Florida
ZIP Code: 33931-5336
Phone: (239) 340-7073

Authorized Official

Name: LAURA LEVINE
Title: DIR HEALTHCARE CONTRACT & ENROLL
Phone: (479) 204-8550

Specialties & Taxonomy Codes

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

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