NPIMap

Organization Active NPI

Wal-Mart Stores East, LP

Doing business as Walmart Vision Center 30-1566

  • Eyewear Supplier
  • Goshen, IN
National Provider Identifier
1053846345
Registry record updated Apr 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
WAL-MART STORES EAST, LP
Doing business as
Walmart Vision Center 30-1566
Practice address
4024 Elkhart Rd Ste 2
Goshen, IN 46526-5801
Phone
(479) 204-1258
Fax
(479) 277-4331
NPI assigned
Apr 25, 2017
Last updated
Apr 25, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
WAL-MART STORES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2017

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

Authorized official

Name
Kylee Fisher
Title
Manager
Phone
(479) 204-1258

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary
Optician 156FX1800X

Addresses

Primary practice location

4024 Elkhart Rd Ste 2
Goshen, IN 46526-5801

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0445
Phone (479) 277-1242

Other names 1

  • Walmart Vision Center 30-1566 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network4,654 organizations share this tax ID, including this one
Part of
Walmart Pharmacy 10-206

Organizations with this tax ID in the same state 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493078400000",
    "number": "1053846345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160445",
            "telephone_number": "479-277-1242",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 ELKHART RD STE 2",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465265801",
            "telephone_number": "479-204-1258",
            "fax_number": "479-277-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES EAST, LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAL-MART STORES, INC",
        "enumeration_date": "2017-04-25",
        "last_updated": "2017-04-25",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "KYLEE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "479-204-1258"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walmart Vision Center 30-1566",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goshen, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.