NPIMap

Organization Active NPI

Wal-Mart Stores East, LP.

Doing business as Walmart Vision Center 30-0625

  • Optician
  • Georgetown, SC
National Provider Identifier
1356117113
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
WAL-MART STORES EAST, LP.
Doing business as
Walmart Vision Center 30-0625
Practice address
1310 N Fraser St
Georgetown, SC 29440-2800
Phone
(843) 546-8946
Fax
(843) 527-5019
NPI assigned
Dec 1, 2023
Last updated
Sep 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Authorized official

Name
Michele Garvey
Title
Director of Health Care Contracting
Phone
(479) 277-2611

Specialties & licenses 2

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

Addresses

Primary practice location

1310 N Fraser St
Georgetown, SC 29440-2800

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0445
Phone (479) 258-2115

Other names 1

  • Walmart Vision Center 30-0625 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network4,654 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": "1701388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1356117113",
    "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",
            "telephone_number": "479-258-2115",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 N FRASER ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294402800",
            "telephone_number": "843-546-8946",
            "fax_number": "843-527-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES EAST, LP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-01",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A",
        "authorized_official_last_name": "GARVEY",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "DIRECTOR OF HEALTH CARE CONTRACTING",
        "authorized_official_telephone_number": "479-277-2611"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walmart Vision Center 30-0625",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.