Wal-Mart Stores, INC
Eyewear Supplier (Equipment, not the service) in Port Angeles, WA. Organization (NPI-2).
NPI number1720168636
StatusActive
Last updated in NPPESJul 28, 2011
Details
- NPI
- 1720168636
- Entity type
- Organization (NPI-2)
- Legal business name
- Wal-Mart Stores, INC
- Organization subpart
- No
- Enumeration date
- Oct 16, 2006
- Last updated
- Jul 28, 2011
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 code | Description | License | State | Primary |
|---|---|---|---|---|
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – | Yes |
| 156FX1800X | Technician/Technologist, Optician | – | – |
Other names
- Wal-Mart Vision Center 30-2196 (Doing Business As)
Practice location
3411 E Koloneles WayPort Angeles, WA 98362
Phone 360-452-6131
Mailing address
702 Sw 8th St.Bentonville, AR 72716-0445
Phone 479-277-1238 · Fax 479-277-4331
Authorized official
Dianna D Painter
Enrollment Specialist
4792771238
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