Wal-Mart Stores East, LP

NPI #1720160658 in Ionia, Michigan

Provider Information

NPI Number: 1720160658
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: Oct 19, 2006
Last Updated: Feb 17, 2015

Practice Location

Address: 152 W SPRAGUE RD.
City: Ionia
State: Michigan
ZIP Code: 48846-9416
Phone: (616) 527-5894

Authorized Official

Name: LAURA LEVINE
Title: DIR HEALTHCARE CONTR
Phone: (479) 204-8550

Specialties & Taxonomy Codes

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

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