NPIMap

Organization Active NPI

Wal-Mart Store East, LP

Doing business as Wal-Mart Vision Center 30-3626

  • Eyewear Supplier
  • Winston Salem, NC
National Provider Identifier
1093870909
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
WAL-MART STORE EAST, LP
Doing business as
Wal-Mart Vision Center 30-3626
Practice address
1330 W. Clemmnonsville Rd.
Winston Salem, NC 27127
Phone
(336) 771-7322
NPI assigned
Dec 22, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

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

Specialties & licenses 2

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

Addresses

Primary practice location

1330 W. Clemmnonsville Rd.
Winston Salem, NC 27127

Mailing address

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

Other names 1

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

National Provider Directory

National Provider Directory
Tax ID family
Ability Network4,659 organizations share this tax ID, including this one

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

Locations

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

NPI Registry JSON

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

{
    "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": "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": "Wal-Mart Vision Center 30-3626",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.