NPIMap

Organization Active NPI

Wal-Mart Stores East, LP

Doing business as Walmart Vision Center 30-3499

  • Eyewear Supplier
  • Jefferson, WI
National Provider Identifier
1184093619
Registry record updated Nov 2, 2015
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 30-3499
Practice address
1520 S Main St
Jefferson, WI 53549-2940
Phone
(920) 605-3004
Fax
(920) 674-2176
NPI assigned
Sep 15, 2015
Last updated
Nov 2, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
WAL-MART STORES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Authorized official

Name
Deb Lauver
Title
Specialist
Phone
(479) 258-2115

Specialties & licenses 2

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

Addresses

Primary practice location

1520 S Main St
Jefferson, WI 53549-2940

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0445

Other names 1

  • Walmart Vision Center 30-3499 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": "1442275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1184093619",
    "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": "1520 S MAIN ST",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535492940",
            "telephone_number": "920-605-3004",
            "fax_number": "920-674-2176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES EAST, LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAL-MART STORES, INC.",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "LAUVER",
        "authorized_official_first_name": "DEB",
        "authorized_official_title_or_position": "SPECIALIST",
        "authorized_official_telephone_number": "479-258-2115"
    },
    "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": "Walmart Vision Center 30-3499",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; 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.