WAL-MART STORES EAST, LP (NPI# 1053846345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053846345 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST, LP |
| Other Organization Name | WALMART VISION CENTER 30-1566 |
| Practice Address |
4024 Elkhart Rd Ste 2 Goshen IN 46526-5801 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 4792041258 |
| Practice Fax Number | 4792774331 |
| Mailing Telephone | 4792771242 |
| Mailing Fax Number | 4792774331 |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2017-04-25 |
| Authorized Official Name | KYLEE FISHER (MANAGER) |
| Authorized Official Telephone | 4792041258 |
| Is Organization Subpart | Y |
| Parent Organization Name | WAL-MART STORES, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers | ||
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| Walmart Vision Center 30-1566 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730798851 | Wal-mart Stores East, Lp | Technician/Technologist | 461 Rt 10 Suite A100, Ledgewood, NJ 07852 | 2020-07-24 |
| 1184156317 | Wal-mart Stores East, Lp | Durable Medical Equipment & Medical Supplies | 270 Heald Way, The Villages, FL 32163-6003 | 2017-03-28 |
| 1730611971 | Wal-mart Stores East, Lp | Durable Medical Equipment & Medical Supplies | 4401 Poole Rd., Raleigh, NC 27603-0000 | 2017-03-28 |
| 1720527955 | Wal-mart Stores East, Lp | Technician/Technologist | 2755 W Holton-whitehall Rd, Whitehall, MI 49461 | 2017-02-21 |
| 1003354580 | Wal-mart Stores East, Lp | Technician/Technologist | 2129 Grand Ave, Yazoo City, MS 39194 | 2017-02-06 |
| 1255874970 | Wal-mart Stores East, Lp | Technician/Technologist | 3410 Sw Market St, Lees Summit, MO 64082 | 2016-11-29 |
| 1538611066 | Wal-mart Stores East, Lp | Technician/Technologist | 546 First Colonial Road, Virginia Beach, VA 23451 | 2016-11-01 |
| 1760933196 | Wal-mart Stores East, Lp | Durable Medical Equipment & Medical Supplies | 1705 S Kings Hwy, Myrtle Beach, SC 29577-4601 | 2016-10-20 |
| 1700335312 | Wal-mart Stores East, Lp | Durable Medical Equipment & Medical Supplies | 3045 Sw Port St Lucie Blvd, Port St Lucie, FL 34953-0000 | 2016-09-23 |
| 1619425683 | Wal-mart Stores East, Lp | Technician/Technologist | 11930 Narcoossee Road, Orlando, FL 32832-0000 | 2016-09-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | WAL-MART STORES EAST, LP | 708 Sw 8th Street, Bentonville, AR 72716 |
| Massachusetts Corporations | WAL-MART STORES EAST, LP | 702 Sw 8th Street, Bentonville, AR 72716 |
| Oklahoma Business Registrations | WAL-MART STORES EAST, LP | 702 Sw 8th Street, Bentonville, AR 72716 |
| Oregon Corporations, Companies and Business Names | WAL-MART STORES EAST, LP, A LIMITED PARTNERSHIP OF DELAWARE | 708 Sw 8th Street, Bentonville, AR 72716 |
| Street Address |
4024 ELKHART RD STE 2 |
| City | GOSHEN |
| State | IN |
| Zip Code | 46526-5801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972522951 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 4024 Elkhart Rd Ste 2, Goshen, IN 46526-5801 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134631344 | Heidi Kauffmann | Social Worker | 2606 Peddler's Village Rd. Suite 210, Goshen, IN 46526 | 2017-10-27 |
| 1952812034 | Blue Diamond Villas | Skilled Nursing Facility | 1510 Sandpiper Lane, Goshen, IN 46526 | 2017-10-17 |
| 1578086534 | Anthony Escotto | Physical Therapist | 223 North Chicago Avenue, Goshen, IN 46526 | 2017-07-21 |
| 1831544774 | April Noelle Hart | Registered Nurse | 2606 Peddlers Village Rd., Suite 215, Goshen, IN 46526 | 2016-04-28 |
| 1639530108 | Amanda Miller | Physical Therapy Assistant | 114 Watertower Court, Goshen, IN 46526 | 2016-03-11 |
| 1720486095 | Gloria White | Pharmacist | 4430 Elkhart Road, C/o Walgreens, Goshen, IN 46526 | 2014-12-18 |
| 1184982472 | Dianna Christine Hoover | Occupational Therapist | 1627 Autumn Blaze Lane, Goshen, IN 46526 | 2012-04-24 |
| 1629361357 | Amy Rebecca Pointon | Nurse Practitioner | 1615 Winsted Dr Ste 1, Goshen, IN 46526 | 2011-05-27 |
| 1659670685 | Michiana Eye Center LLC | Optometrist | 1747 Stafford Ct, Goshen, IN 46526 | 2011-03-16 |
| 1467759001 | Natasha Candace Pontius | Occupational Therapy Assistant | 2400 College Aveune, Goshen, IN 46526 | 2011-02-17 |
| Find all providers in zip 46526 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518263086 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 4024 Elkhart Rd, Ste #23, Goshen, IN 46526-5807 | 2011-02-01 |
| 1003971243 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 4024 Elkharte Rd, Goshen Market Ctr Ste #23, Goshen, IN 46526-5807 | 2006-12-27 |
| 1013347723 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 4522 Elkhart Rd, Goshen, IN 46526-5822 | 2013-11-15 |
| 1467585885 | Boling Vision Center, LLC | Eyewear Supplier (Equipment, not the service) | 1615 Winsted Dr, Goshen, IN 46526-4696 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730737610 | Net-works Solutions, LLC | Eyewear Supplier (Equipment, not the service) | 7114 Munsee Ln, Indianapolis, IN 46260-4069 | 2019-09-03 |
| 1801443742 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 49 W Maryland St Ste 179, Indianapolis, IN 46204-3543 | 2019-08-26 |
| 1609339910 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 1201 Cross Pointe Place, Evansville, IN 47715 | 2019-04-12 |
| 1760993810 | Longe Enterprises Corp | Eyewear Supplier (Equipment, not the service) | 5711 Ymca Park Dr East, Fort Wayne, IN 46835 | 2017-10-17 |
| 1023532199 | Dr Mark Lynn & Associates, Pllc | Eyewear Supplier (Equipment, not the service) | 5720 Grape Rd., Mishawaka, IN 46545-1245 | 2017-08-01 |
| 1467976472 | Grifflands Optical | Eyewear Supplier (Equipment, not the service) | 1951 West Glen Park Ave, Griffith, IN 46319 | 2017-08-01 |
| 1992233738 | Dr Mark Lynn & Associates, Pllc | Eyewear Supplier (Equipment, not the service) | 2894 E 3rd St Ste 155, Bloomington, IN 47401-5423 | 2017-05-24 |
| 1710338231 | Dr. Mark Lynn & Associates, Pllc | Eyewear Supplier (Equipment, not the service) | 4440 S Us Highway 41, Ste. 102, Terre Haute, IN 47802-4409 | 2016-06-27 |
| 1407216492 | Dr Mark Lynn & Associates Pllc | Eyewear Supplier (Equipment, not the service) | 2141 Sagamore Pkwy South, Lafayette, IN 47905-5109 | 2016-03-03 |
| 1588038335 | Ditto Technologies, Inc | Eyewear Supplier (Equipment, not the service) | 420 Nw 5th St Ste 2b, Evansville, IN 47708-1333 | 2015-11-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.