WAL-MART STORES, INC (NPI# 1114017357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114017357 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES, INC |
| Other Organization Name | VISION CENTER 30-2485 |
| Practice Address |
476999 Highway 95 Ponderay ID 83852-9738 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0235 |
| Practice Telephone | 2082658332 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | NICOLE D GENTILE (NPI COORDINATOR) |
| Authorized Official Telephone | 3167885580 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers | ||
| X | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| Vision Center 30-2485 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295190510 | Wal-mart Stores, Inc | Durable Medical Equipment & Medical Supplies | 600 W Martin Luther King Blvd, Fayetteville, AR 72701-6443 | 2015-12-31 |
| 1871961185 | Wal-mart Stores, Inc | Technician/Technologist | 3001 E Highway 7, Montevideo, MN 56265-4556 | 2015-09-03 |
| 1821407909 | Wal-mart Stores, Inc | Technician/Technologist | 19191 N Kelsey St, Monroe, WA 98272-1459 | 2014-08-04 |
| 1396155701 | Wal-mart Stores, Inc | Technician/Technologist | 21320 Sw Langer Farm, Sherwood, OR 97140 | 2014-05-07 |
| 1154755197 | Wal-mart Stores, Inc | Durable Medical Equipment & Medical Supplies | 36318 Memory Lane, Polson, MT 59860 | 2013-08-27 |
| 1235578907 | Wal-mart Stores, Inc | Technician/Technologist | 1000 Old Red Trl Ne, Mandan, ND 58554-1591 | 2013-06-17 |
| 1821435520 | Wal-mart Stores, Inc | Technician/Technologist | 530 Woollomes Ave, Delano, CA 93215 | 2013-06-04 |
| 1093055147 | Wal-mart Stores, Inc | Durable Medical Equipment & Medical Supplies | 671 E Apache Blvd, Suite 128, Tempe, AZ 85281-6717 | 2013-02-27 |
| 1639350564 | Wal-mart Stores, Inc | Eyewear Supplier (Equipment, not the service) | 3031 1st St S, Willmar, MN 56201-4240 | 2007-11-20 |
| 1326229253 | Wal-mart Stores, Inc | Eyewear Supplier (Equipment, not the service) | 1205 S Route 31, Crystal Lake, IL 60014 | 2007-11-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | WAL-MART STORES, INC. | 702 Sw 8th Street, Bentonville, AR 72716 |
| Vermont Business Registrations | WAL-MART STORES, INC. | 702 Sw 8th Street, Bentonville, AR 72716 |
| Massachusetts Corporations | WAL-MART STORES, INC. | 702 Sw 8th Street, Bentonville, AR 72716 |
| Oklahoma Business Registrations | WAL-MART STORES, INC. | 702 Sw 8th St, Bentonville, AR 72716 |
| Street Address |
476999 HIGHWAY 95 |
| City | PONDERAY |
| State | ID |
| Zip Code | 83852-9738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124060041 | Paul Erwin Koch | Optometrist | 476999 Highway 95, Ponderay, ID 83852-9738 | 2006-06-12 |
| 1790194835 | Daniel Schauwecker | Pharmacist | 476999 Highway 95, Ponderay, ID 83852-9738 | 2014-08-02 |
| 1720495807 | Kayla Dotson | Pharmacist | 476999 Highway 95, Ponderay, ID 83852-9738 | 2014-07-21 |
| 1922415025 | Amy Mcgrath | Pharmacist | 476999 Highway 95, Ponderay, ID 83852-9738 | 2014-07-21 |
| 1255574711 | Dr. Paul E. Koch, Optometrist, P.c | Optometrist | 476999 Highway 95, C/o Walmart Vision Center, Ponderay, ID 83852-9738 | 2009-04-14 |
| 1356368609 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 476999 Highway 95, Ponderay, ID 83852-9738 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346606647 | Vern Stairs | Pharmacist | 476999 Us-95, Walmart Supercenter, Ponderay, ID 83852 | 2016-01-04 |
| 1083809727 | Michael R Dibenedetto Md Pllc | Orthopaedic Surgery | 30544 Hwy 200, Ste 102, Ponderay, ID 83852 | 2007-09-06 |
| 1811009988 | David Paul Cox | Dentist | 477542 Hwy 95 N, Ponderay, ID 83852 | 2006-08-31 |
| 1861774291 | Michael David Schicker | Orthopaedic Surgery | 30544 Highway 200 Ste 102, Ponderay, ID 83852 | 2011-09-12 |
| 1750410825 | Glacier Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 205 Vermeer Dr, Suite C, Ponderay, ID 83852-1660 | 2007-03-05 |
| 1083949531 | Mario E Roxas | Naturopath | 476864 Highway 95, Suite #3, Ponderay, ID 83852-5000 | 2009-10-15 |
| 1942716246 | Darwin L Hurst | Family Medicine | 30544 Highway 200 Ste 101, Ponderay, ID 83852-5005 | 2017-12-21 |
| 1902036734 | Innovative Anesthesia | Nurse Anesthetist, Certified Registered | 30544 Highway 200 Ste 201, Pend Oreille Surgery Center, Ponderay, ID 83852-5005 | 2009-07-14 |
| 1255597811 | Travis Lee Taylor | Nurse Practitioner | 30544 Highway 200 Ste 102, Ponderay, ID 83852-5005 | 2008-08-04 |
| 1982741195 | Ryan Leisy | Chiropractor | 30544 Highway 200 Ste 330, Ponderay, ID 83852-5005 | 2007-01-30 |
| Find all providers in zip 83852 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699126656 | Scott J Mccurdy | Technician/Technologist | 110 E 1st N, #2, Rexburg, ID 83440-1614 | 2016-06-30 |
| 1194194605 | Wal-mart Stores, Inc. | Technician/Technologist | 6403 W Pointe Pkwy, Post Falls, ID 83854-5517 | 2015-09-15 |
| 1467837583 | Wal-mart Stores, Inc. | Technician/Technologist | 303 E Moody Rd, Rexburg, ID 83440 | 2015-07-30 |
| 1801271168 | National Vision, Inc. | Technician/Technologist | 16439 N Market Place Blvd, Nampa, ID 83687-5018 | 2015-07-28 |
| 1427467208 | Mathew Petersen | Technician/Technologist | 409 S 8th St, Boise, ID 83702-7142 | 2014-08-06 |
| 1588918676 | Sue Soroor Didehban | Technician/Technologist | 7447 W Emerald St Ste 105, Boise, ID 83704-5003 | 2012-10-29 |
| 1629368725 | Rexford Capital Partners, Inc | Technician/Technologist | 649 Sun Valley Road, Ketchum, ID 83340 | 2011-04-11 |
| 1992001663 | America's Best Contacts & Eyeglasses | Technician/Technologist | 1239 Poleline Rd E Ste 312c, Twin Falls, ID 83301-3469 | 2011-01-28 |
| 1750696951 | Wal-mart Stores Inc | Technician/Technologist | 402 W Honeysuckle Ave, Hayden, ID 83835 | 2010-08-11 |
| 1316278153 | America's Best Contacts & Eyeglasses | Technician/Technologist | 1776 Hurley Dr, Pocatello, ID 83202-1909 | 2010-01-19 |
| 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.