Wal-Mart Stores East, LP
NPI #1881743995 in Ogdensburg, New York
Provider Information
- NPI Number
- 1881743995
- Entity Type
- Organization
- Organization Name
- Wal-Mart Stores East, LP
- Primary Specialty
- Eyewear Supplier
- Enumeration Date
- Jan 9, 2007
- Last Updated
- Sep 11, 2025
Practice Location
- Address
- 3000 FORD STREET EXT
- City
- Ogdensburg
- State
- New York
- ZIP Code
- 13669-4480
- Phone
- (315) 394-7902
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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