Provider Demographics
NPI:1467501718
Name:WALMAN OPTICAL COMPANY
Entity Type:Organization
Organization Name:WALMAN OPTICAL COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-520-6000
Mailing Address - Street 1:9200 WYOMING AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-1857
Mailing Address - Country:US
Mailing Address - Phone:763-515-5590
Mailing Address - Fax:763-515-5592
Practice Address - Street 1:9200 WYOMING AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-1857
Practice Address - Country:US
Practice Address - Phone:763-515-5590
Practice Address - Fax:763-515-5592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier