Wal Mart Stores, Inc.
NPI #1811046253 in Winnemucca, Nevada
Provider Information
- NPI Number
- 1811046253
- Entity Type
- Organization
- Organization Name
- Wal Mart Stores, Inc.
- Primary Specialty
- Eyewear Supplier
- Enumeration Date
- Jan 8, 2007
- Last Updated
- Sep 11, 2025
Practice Location
- Address
- 3010 POTATO RD
- City
- Winnemucca
- State
- Nevada
- ZIP Code
- 89445-3665
- Phone
- (775) 625-3777
Authorized Official
- Name
- MR. G WESLEY CRAINSHAW III
- Title
- PROVIDER ENROLLMENT SPECIALIST
- Phone
- (479) 277-1850
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician/Technologist - Optician — Optician |
| Eyewear Supplier |
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