NPIMap

Organization Active NPI

Wal-Mart Puerto Rico

Doing business as Sams Club Optical 30-4748

  • Eyewear Supplier
  • Bayamon South, PR
National Provider Identifier
1992007074
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
WAL-MART PUERTO RICO
Doing business as
Sams Club Optical 30-4748
Practice address
Carretera 16 & Carretera 830
Bayamon South, PR 00957
Phone
(787) 730-3652
NPI assigned
Nov 23, 2010
Last updated
Nov 23, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
WAL-MART STORES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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

Authorized official

Name
Dianna Painter
Title
Enrollment Specialist
Phone
(479) 277-1238

Specialties & licenses 2

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

Addresses

Primary practice location

Carretera 16 & Carretera 830
Bayamon South, PR 00957

Mailing address

702 SW 8TH St
Bentonville, AR 72716

Other names 1

  • Sams Club Optical 30-4748 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network66 organizations share this tax ID, including this one
Part of
Wal Mart Pharmacy 10 2039

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290470400000",
    "number": "1992007074",
    "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": "72716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 16 & CARRETERA 830",
            "city": "BAYAMON SOUTH",
            "state": "PR",
            "postal_code": "00957",
            "telephone_number": "787-730-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART PUERTO RICO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAL-MART STORES INC",
        "enumeration_date": "2010-11-23",
        "last_updated": "2010-11-23",
        "status": "A",
        "authorized_official_last_name": "PAINTER",
        "authorized_official_first_name": "DIANNA",
        "authorized_official_title_or_position": "ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "479-277-1238"
    },
    "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": "Sams Club Optical 30-4748",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; 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.