Wal-Mart Stores East, LP

NPI #1962877415 in Indian Harbour Beach, Florida

Provider Information

NPI Number: 1962877415
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: Dec 9, 2015
Last Updated: Dec 9, 2015

Practice Location

Address: 1001 E EAU GALLIE BLVD
City: Indian Harbour Beach
State: Florida
ZIP Code: 32937-4907
Phone: (321) 773-8453

Authorized Official

Name: LAURA LEVINE
Title: DIR HEALTHCARE CONTRACT&ENROLL
Phone: (321) 773-8453

Specialties & Taxonomy Codes

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

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