Wal-Mart Stores INC

NPI #1710221023 in Princeton, Minnesota

Provider Information

NPI Number: 1710221023
Entity Type: Organization
Organization Name: Wal-Mart Stores INC
Subpart: Yes (part of a larger organization)
Parent Organization: WAL-MART STORES INC
Primary Specialty: Eyewear Supplier
Enumeration Date: Nov 27, 2012
Last Updated: Nov 27, 2012

Practice Location

Address: 300 21ST AVE N
City: Princeton
State: Minnesota
ZIP Code: 55371
Phone: (763) 389-1561

Authorized Official

Name: AMY POWERS
Title: SPECIALIST, PLAN ENROLLMENT
Phone: (479) 204-0709

Specialties & Taxonomy Codes

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

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