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Wal-Mart Stores, INC.

Eyewear Supplier (Equipment, not the service) in Buffalo, MN. Organization (NPI-2).

NPI number1124123369
StatusActive
Last updated in NPPESSep 11, 2025

Details

NPI
1124123369
Entity type
Organization (NPI-2)
Legal business name
Wal-Mart Stores, INC.
Organization subpart
No
Enumeration date
Sep 13, 2006
Last updated
Sep 11, 2025

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
332H00000X Eyewear Supplier (Equipment, not the service)––Yes
156FX1800X Technician/Technologist, Optician––

Other names

  • Vision Center 30-1577 (Doing Business As)

Practice location

1315 Highway 25 N
Buffalo, MN 55313-1937

Phone 763-682-2958

Mailing address

702 Sw 8th St
Bentonville, AR 72716-0235

Authorized official

Tammy J Boyd
Contract Coordinator
4792771359

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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