Provider Demographics
NPI:1265656649
Name:WAL-MART STORES, INC.
Entity Type:Organization
Organization Name:WAL-MART STORES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NPI ASSOCIATE
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-277-1703
Mailing Address - Street 1:702 SW 8TH ST.
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AZ
Mailing Address - Zip Code:72716-0235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16077 HWY 280
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:AL
Practice Address - Zip Code:35043
Practice Address - Country:US
Practice Address - Phone:205-678-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty