Wal-Mart Stores, Inc.

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

WAL-MART STORES, INC.

Doing business as

Vision Center 30-1609

Practice address

100 Southeast 29TH St.
Grand Rapids, MI 55744

Phone

(218) 326-1101

NPI assigned

Apr 23, 2008

Last updated

Apr 23, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David J Simmons

Title

Npi Associate

Phone

(479) 277-9373

Specialties & licenses 2

Addresses

Other names 1

• Vision Center 30-1609 Doing business as

Tax ID family

Ability Network2,173 organizations share this tax ID, including this one

Locations

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1902071764",
    "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",
            "telephone_number": "479-277-9373",
            "fax_number": "479-277-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SOUTHEAST 29TH ST.",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "55744",
            "telephone_number": "218-326-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "NPI ASSOCIATE",
        "authorized_official_telephone_number": "479-277-9373"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Center 30-1609",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Treasure Kathleen Wakefield
• Rebekah Wakeman, M.D.
• Kimberli Wakley
• Wal-Mart Stores East LP (Walmart Pharmacy 10-2493)
• Wal-Mart Stores East, LP (Vision Center 30-2493)
• Anne Marie Walberer
• Mikaela Walburg, LMSW
• Andrea Walcott
• Dawn Renee Walcott, LMSW
• Emily Walcott, CTRS, ATRIC

• Optician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Optician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.