Wal-Mart Stores, Inc.

NPI #1962567867 in Woodstock, Illinois

Provider Information

NPI Number
1962567867
Entity Type
Organization
Organization Name
Wal-Mart Stores, Inc.
Primary Specialty
Eyewear Supplier
Enumeration Date
Dec 22, 2006
Last Updated
Sep 11, 2025

Practice Location

Address
1275 LAKE AVE
ZIP Code
60098-7415
Phone
(815) 206-0998

Authorized Official

Name
BJ RICE
Title
PROVIDER ENROLLMENT SPEICIALIST
Phone
(479) 277-9835

Specialties & Taxonomy Codes

Specialty
Technician/Technologist - OpticianOptician
Eyewear Supplier

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