NPIMap

Organization Active NPI

Wal-Mart Stores, Inc

Doing business as Wal-Mart Vision Center 30-4171

  • Eyewear Supplier
  • Garden Grove, CA
National Provider Identifier
1114355393
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
WAL-MART STORES, INC
Doing business as
Wal-Mart Vision Center 30-4171
Practice address
11822 Gilbert St
Garden Grove, CA 92841-2720
Phone
(714) 591-1304
Fax
(714) 590-1206
NPI assigned
Oct 24, 2013
Last updated
May 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Authorized official

Name
Deb Lauver
Title
Specialist Plan Enrollment
Phone
(479) 273-4885

Specialties & licenses 2

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

Addresses

Primary practice location

11822 Gilbert St
Garden Grove, CA 92841-2720

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0445

Other names 1

  • Wal-Mart Vision Center 30-4171 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network2,177 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

NPI Registry JSON

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400457600000",
    "number": "1114355393",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11822 GILBERT ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928412720",
            "telephone_number": "714-591-1304",
            "fax_number": "714-590-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-24",
        "last_updated": "2014-05-19",
        "status": "A",
        "authorized_official_last_name": "LAUVER",
        "authorized_official_first_name": "DEB",
        "authorized_official_title_or_position": "SPECIALIST PLAN ENROLLMENT",
        "authorized_official_telephone_number": "479-273-4885"
    },
    "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 30-4171",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; 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.