NPIMap

Organization Active NPI

Wal-Mart Stores East, LP

  • Eyewear Supplier
  • Fayetteville, GA
National Provider Identifier
1346339207
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 STORES EAST, LP
Practice address
125 Pavilion Pkwy
Fayetteville, GA 30214-4098
Phone
(770) 460-0947
NPI assigned
Oct 11, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Nicole D Gentile
Title
Npi Coordinator
Phone
(316) 788-5580

Corporate family (same tax ID) 24

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

National Provider Directory

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

Specialties & licenses 2

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

Addresses

NPPES NPI Registry

Primary practice location

125 Pavilion Pkwy
Fayetteville, GA 30214-4098

Mailing address

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

Other names 1

NPPES NPI Registry
  • Vision Center 30-0594 Doing business as

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1346339207",
    "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": "125 PAVILION PKWY",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144098",
            "telephone_number": "770-460-0947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES EAST, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GENTILE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "NPI COORDINATOR",
        "authorized_official_telephone_number": "316-788-5580"
    },
    "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": "Vision Center 30-0594",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, GA

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.