Wal-Mart Stores, Inc
Organization Active NPI Eyewear Supplier · Ephrata, WA
NPI 1720160682 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1720160682
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Eyewear Supplier 332H00000X
- Legal business name
- WAL-MART STORES, INC
- Practice address
- 1399 Southeast Blvd
Ephrata, WA 98823-2617 - Phone
- (509) 754-8837
- NPI assigned
- Oct 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Nicole D Gentile
- Title
- Npi Coordinator
- Phone
- (316) 788-5580
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Ability Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician |
156FX1800X | |||
| Eyewear Supplier | 332H00000X | Yes |
Addresses
Primary practice location
1399 Southeast Blvd
Ephrata, WA 98823-2617
Mailing address
702 SW 8TH St.
Bentonville, AR 72716-0235
Other names
- Vision Center 30-3260
NPI Registry JSON
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1720160682",
"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": "1399 SOUTHEAST BLVD",
"city": "EPHRATA",
"state": "WA",
"postal_code": "988232617",
"telephone_number": "509-754-8837"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WAL-MART STORES, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-19",
"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 30-3260",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Ephrata, WA
- Jessica Mae Stredwick
- Apryl Sundberg
- Mariah Marie Taylor
- Thrifty Payless Inc
- Gary Tracy
- Walia Adult Family Homecare LLC
- Walmart
- Walmart Inc.
- Michelle K Walsh
- Charles Michael Webberley
All providers in Ephrata, WA · Eyewear Supplier in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.