NPIMap

Organization Active NPI

Wal-Mart Store, Inc.

  • Eyewear Supplier
  • Lake Havasu City, AZ
National Provider Identifier
1386819142
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
WAL-MART STORE, INC.
Practice address
5695 Hwy 95 N
Lake Havasu City, AZ 86403-9646
Phone
(928) 764-3755
Fax
(928) 472-2815
NPI assigned
Apr 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Sarah Little
Title
Director Healthcare Contracting
Phone
(479) 277-2500

Specialties & licenses 2

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

Addresses

Primary practice location

5695 Hwy 95 N
Lake Havasu City, AZ 86403-9646

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0445
Phone (479) 277-2500

Other names 2

  • Vision Center 30-1364 Doing business as
  • Walmart Vision Center 30-1364 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network2,173 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

Locations

5695 Highway 95 N
Lake Havasu City, AZ 86404
Phone (928) 764-3737

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1386819142",
    "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": "479-277-2500",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5695 HWY 95 N",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864039646",
            "telephone_number": "928-764-3755",
            "fax_number": "928-472-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "DIRECTOR HEALTHCARE CONTRACTING",
        "authorized_official_telephone_number": "479-277-2500"
    },
    "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 30-1364",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walmart Vision Center 30-1364",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.