WAL-MART STORES INC (NPI# 1205260148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205260148 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES INC |
| Other Organization Name | WAL-MART VISION CENTER 30-5839 |
| Practice Address |
3615 Crater Lake Hwy Medford OR 97504-9259 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 5417723451 |
| Mailing Telephone | 4792734885 |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2013-08-28 |
| Authorized Official Name | MRS. LAURA LEVINE (MANAGER OF GOVERMENT CONTRACTS) |
| Authorized Official Telephone | 4792048550 |
| 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 |
|---|---|
| Wal-Mart Vision Center 30-5839 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871980219 | Wal-mart Stores Inc | Technician/Technologist | 4425 Venetucci Blvd, Fountain, CO 80906 | 2015-04-23 |
| 1932590999 | Wal-mart Stores Inc | Durable Medical Equipment & Medical Supplies | 605 Orchard Dr, Hillsboro, KS 67063-3502 | 2015-02-12 |
| 1538558994 | Wal-mart Stores Inc | Technician/Technologist | 3460 W Chandler Blvd, Chandler, AZ 85226-5065 | 2015-01-22 |
| 1861897134 | Wal-mart Stores Inc | Durable Medical Equipment & Medical Supplies | 1105 E 15th St, Ellsworth, KS 67439-8548 | 2014-10-29 |
| 1316342686 | Wal-mart Stores Inc | Durable Medical Equipment & Medical Supplies | 120 W Rosewood St, Rose Hill, KS 67133-9301 | 2014-10-29 |
| 1578967212 | Wal-mart Stores Inc | Pharmacy | 1531 E Highway 64, Coal Hill, AR 72832-8704 | 2014-10-09 |
| 1568865368 | Wal-mart Stores Inc | Durable Medical Equipment & Medical Supplies | 720 N Hwy 71, Mansfield, AR 72940 | 2014-10-07 |
| 1497158349 | Wal-mart Stores Inc | Durable Medical Equipment & Medical Supplies | 900 E Ross St, Clearwater, KS 67026-7849 | 2014-10-07 |
| 1952704892 | Wal-mart Stores Inc | Pharmacy | 154 E Roller Ave, Decatur, AR 72722-9446 | 2014-10-07 |
| 1396148243 | Wal-mart Stores Inc | Durable Medical Equipment & Medical Supplies | 505 Housatonic St, Burlington, KS 66839-1712 | 2014-10-07 |
| Street Address |
3615 CRATER LAKE HWY |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-9259 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184711632 | Wal-mart Stores, Inc | Technician/Technologist | 3615 Crater Lake Hwy, Medford, OR 97504-9259 | 2006-10-06 |
| 1801266234 | Tiburcio Alvarez Jr | Pharmacist | 3615 Crater Lake Hwy, Medford, OR 97504-9259 | 2015-09-28 |
| 1215306212 | Giang Huong Phan | Pharmacist | 3615 Crater Lake Hwy, Medford, OR 97504-9259 | 2015-09-20 |
| 1053712091 | Jeffrey Harder | Pharmacist | 3615 Crater Lake Hwy, Medford, OR 97504-9259 | 2014-09-09 |
| 1730597410 | Michael N Le | Pharmacist | 3615 Crater Lake Hwy, Medford, OR 97504-9259 | 2014-07-25 |
| 1427497643 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 3615 Crater Lake Hwy, Medford, OR 97504-9259 | 2013-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| 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 |
|---|---|---|---|---|
| 1629287032 | South Jersey Eye Physicians Pa | Eyewear Supplier (Equipment, not the service) | 103 Old Marlton Pike Ste 216, Medford, NJ 08055-8772 | 2007-05-22 |
| 1316091341 | Usv Optical Inc.. | Eyewear Supplier (Equipment, not the service) | 909 The Fellsway, Medford, MA 02155-4151 | 2007-01-23 |
| 1841356151 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 501 Medford Ctr, Medford S/c, Medford, OR 97504-6004 | 2006-12-29 |
| 1922183557 | Budd Optical | Eyewear Supplier (Equipment, not the service) | 175 Route 70 Ste 23, Medford, NJ 08055-2355 | 2006-10-25 |
| 1720170756 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 1600 North Riverside Avenue, Medford, OR 97501 | 2006-09-28 |
| 1508804550 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 2424 Crater Lake Hwy, Medford, OR 97504-4181 | 2006-06-03 |
| 1093321747 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 278 Middlesex Ave, Medford, MA 02155-5066 | 2020-09-18 |
| 1649678616 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 1740 Delta Waters Rd, Suite 100, Medford, OR 97504-9175 | 2014-12-08 |
| 1982879292 | Medical Eye Center Optical Inc | Eyewear Supplier (Equipment, not the service) | 815 E Main St, Medford, OR 97504-7133 | 2008-04-28 |
| 1396955001 | Jason M. Gilbert Mdpc | Eyewear Supplier (Equipment, not the service) | 101 Main Street, Suite 208, Medford, MA 02155 | 2007-05-23 |
| Find all providers in MEDFORD | ||||
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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.