NPIMap

Organization Active NPI

Wal-Mart Stores East, L.P.

  • Optician
  • Farmingdale, NY
National Provider Identifier
1013048529
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
WAL-MART STORES EAST, L.P.
Practice address
965 Broadhollow Rd
Farmingdale, NY 11735
Phone
(631) 694-3520
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cory Jon Gundberg
Title
SVP Health & Wellness
Phone
(479) 277-9621

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1800X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

965 Broadhollow Rd
Farmingdale, NY 11735

Mailing address

702 SW 8TH Street
Bentonville, AR 72716-0235
Phone (479) 277-9373

Other names 1

  • Vision Center 30-5295 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network4,651 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

965 Broadhollow Rd
Farmingdale, NY 11735
Phone (631) 694-3520

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536019200000",
    "number": "1013048529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH STREET",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160235",
            "telephone_number": "479-277-9373",
            "fax_number": "479-277-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 BROADHOLLOW RD",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "11735",
            "telephone_number": "631-694-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES EAST, L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2018-09-04",
        "status": "A",
        "authorized_official_last_name": "GUNDBERG",
        "authorized_official_first_name": "CORY",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "SVP HEALTH & WELLNESS",
        "authorized_official_telephone_number": "479-277-9621"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Center 30-5295",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vision Center 30-5295",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmingdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.