Wal-Mart Stores INC

NPI #1861742256 in Lakeville, Minnesota

Provider Information

NPI Number: 1861742256
Entity Type: Organization
Organization Name: Wal-Mart Stores INC
Primary Specialty: Eyewear Supplier
Enumeration Date: Sep 13, 2012
Last Updated: Sep 13, 2012

Practice Location

Address: 20710 KEOKUK AVE
City: Lakeville
State: Minnesota
ZIP Code: 55044-6620
Phone: (952) 469-3944

Authorized Official

Name: DIANNA PAINTER
Title: ENROLLMENT SPECIALIST
Phone: (479) 277-1238

Specialties & Taxonomy Codes

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

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