NPIMap

Organization Active NPI

Walman Optical Company

  • Eyewear Supplier
  • Missoula, MT
National Provider Identifier
1215051396
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
WALMAN OPTICAL COMPANY
Practice address
1245 S 3Rd St W
Missoula, MT 59801-2333
Phone
(406) 549-6429
Fax
(800) 551-3335
NPI assigned
Mar 16, 2007
Last updated
Aug 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Authorized official

Name
Bryan Schueler
Title
Vice President and General Manager
Phone
(612) 520-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

1245 S 3Rd St W
Missoula, MT 59801-2333

Mailing address

1245 S 3Rd St W
Missoula, MT 59801-2333
Phone (406) 549-6429

Other identifiers 3

IdentifierTypeStateIssuer
0550095MedicaidMT
5520008OtherMTCHIP PROVIDER NUMBER
000029765OtherMTDEPT OF CORRECTIONS #

National Provider Directory

National Provider Directory
Tax ID family
Walman Optical Company7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

1245 S 3rd St W
Missoula, MT 59801
Phone (406) 549-6429

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471392000000",
    "number": "1215051396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 S 3RD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598012333",
            "telephone_number": "406-549-6429",
            "fax_number": "800-551-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 S 3RD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598012333",
            "telephone_number": "406-549-6429",
            "fax_number": "800-551-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALMAN OPTICAL COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2016-08-17",
        "status": "A",
        "authorized_official_last_name": "SCHUELER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "VICE PRESIDENT AND GENERAL MANAGER",
        "authorized_official_telephone_number": "612-520-6000"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0550095",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIP PROVIDER NUMBER",
            "identifier": "5520008",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF CORRECTIONS #",
            "identifier": "000029765",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.