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Wal-Mart Store East, LP

Organization Active NPI Eyewear Supplier · Winston Salem, NC

NPI 1093870909 · NPPES record last updated Sep 11, 2025

Key facts

NPI
1093870909
Entity type
Organization (NPI type 2)
Primary specialty
Eyewear Supplier 332H00000X
Legal business name
WAL-MART STORE EAST, LP
Practice address
1330 W. Clemmnonsville Rd.
Winston Salem, NC 27127
Phone
(336) 771-7322
NPI assigned
Dec 22, 2006
Organization subpart
No

Authorized official

Name
BJ Rice
Title
Provider Enrollment Specialist
Phone
(479) 277-9835

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Ability Network (4,651 organizations share this tax ID)

Locations

1330 W Clemmonsville Road Ext
Winston Salem, NC 27127
Phone (336) 771-7322

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 156FX1800X
Eyewear Supplier 332H00000X Yes

Addresses

Primary practice location

1330 W. Clemmnonsville Rd.
Winston Salem, NC 27127

Mailing address

702 SW 8TH St.
Bentonville, AR 72716-0235

Other names

  • Wal-Mart Vision Center 30-3626 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 11, 2025.

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1093870909",
    "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": "727160235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 W. CLEMMNONSVILLE RD.",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27127",
            "telephone_number": "336-771-7322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORE EAST, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "BJ",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "479-277-9835"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wal-Mart Vision Center 30-3626",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

All providers in Winston Salem, NC · Eyewear Supplier in North Carolina

Sources for this page

Verify at the official NPI Registry.