WAL-MART STORES EAST LP (NPI# 1245520055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245520055 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES EAST LP |
| Other Organization Name | VISION CENTER 30-1650 |
| Practice Address |
825 E Green Bay Ave Saukville WI 53080 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 2622849616 |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2011-04-13 |
| Authorized Official Name | DIANNA PAINTER (ENROLLMENT SPECIALIST) |
| Authorized Official Telephone | 4792771238 |
| 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 |
|---|---|
| Vision Center 30-1650 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437657426 | Wal-mart Stores East Lp | Pharmacy | 14325 Sw 268th Ter, Homestead, FL 33032-7555 | 2018-01-25 |
| 1003323387 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 73 Fellowship, Mt Laurel, NJ 08054 | 2018-01-08 |
| 1033623236 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 820 Balmy Beach Dr, Apopka, FL 32703-0000 | 2017-11-27 |
| 1477065704 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 337 Pinewood Rd, Sumter, SC 29150-5442 | 2017-10-26 |
| 1841709516 | Wal-mart Stores East Lp | Pharmacy | 1109 W Corbett Ave, Swansboro, NC 28584-8461 | 2017-09-26 |
| 1396264305 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | Nec Landstar and Arbor Meadows Blvd, Orlando, FL 32801-0000 | 2017-09-12 |
| 1720506967 | Wal-mart Stores East Lp | Pharmacy | 955 S Woodland Blvd, Deland, FL 32720-0000 | 2017-09-08 |
| 1164944104 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 7360 Navarre Pkwy, Navarre, FL 32566-7752 | 2017-07-12 |
| 1568984912 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3655 Browns Bridge Rd, Cumming, GA 30028 | 2017-07-07 |
| 1518498534 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 5001 Nine Mile Rd, Richmond, VA 23223-5732 | 2017-03-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Wal-Mart Stores East LP | 702 Sw 8th St, Bentonville, Arkansas 72716-0555 |
| Street Address |
825 E GREEN BAY AVE |
| City | SAUKVILLE |
| State | WI |
| Zip Code | 53080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457378507 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 825 E Green Bay Ave, Saukville, WI 53080-2618 | 2006-07-16 |
| 1699373258 | Gina Lynn Lusis | Pharmacist | 825 E Green Bay Ave, Saukville, WI 53080-2618 | 2020-10-15 |
| 1568060044 | Susan Annette Goethel | Pharmacist | 825 E Green Bay Ave, Saukville, WI 53080-2611 | 2020-10-15 |
| 1265030225 | Benjamin William Mattila | Pharmacist | 825 E Green Bay Ave, Saukville, WI 53080-2611 | 2020-10-13 |
| 1447858436 | Luke William Schueller | Pharmacist | 825 E Green Bay Ave, Saukville, WI 53080-2618 | 2020-10-13 |
| 1851670921 | Saukville Family Eye Center LLC | Optometrist | 825 E Green Bay Ave, Saukville, WI 53080-2618 | 2011-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437757069 | Kerri Lynn Garant | Pharmacist | Walmart Pharmacy 10-1650, 825 E. Green Bay Avenue, Saukville, WI 53080 | 2020-10-15 |
| 1619527090 | Latisha Irene Metealf | Technician | 604 W Hillcrest Rd Apt 111, Saukville, WI 53080 | 2019-09-17 |
| 1578841854 | Calvin Donald Thomas | Physical Therapist | 516 East Green Bay Ave, Saukville, WI 53080 | 2011-08-03 |
| 1578681748 | Julie Schueller | Physical Therapist | 516 E. Green Bay Ave, Saukville, WI 53080 | 2007-03-27 |
| 1922145101 | Ty C. Wade | Chiropractor | 620 E. Green Bay Ave., Suite 104, Saukville, WI 53080 | 2007-01-30 |
| 1427116375 | Stuart W Natale | Optometrist | 289 E Green Bay Ave, Saukville, WI 53080 | 2006-12-04 |
| 1659590370 | Diane Mary Ott | Physical Therapist | 516 E Green Bay Ave, Saukville, WI 53080 | 2007-04-24 |
| 1902134224 | Knutson | Durable Medical Equipment & Medical Supplies | N5272 Highway I, Saukville, WI 53080-1040 | 2009-11-24 |
| 1962733790 | Nancy Evon Knutson | Licensed Practical Nurse | N5272 Highway I, Saukville, WI 53080-1040 | 2010-01-19 |
| 1275649790 | Ronald Paul Stifter | Dentist | 2659 Hawthorne Dr, Saukville, WI 53080-1109 | 2006-08-21 |
| Find all providers in zip 53080 | ||||
| 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 |
|---|---|---|---|---|
| 1437485125 | Great Lakes Family Vision Sc | Eyewear Supplier (Equipment, not the service) | 289 E Green Bay Ave, Saukville, WI 53080-2006 | 2009-10-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658772 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1073 E Johnson St, Fond Du Lac, WI 54935-8919 | 2020-10-27 |
| 1578170247 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 120 N Grand Ave Ste 102, Sun Prairie, WI 53590-9007 | 2020-09-28 |
| 1639784622 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2268 W Mason St, Green Bay, WI 54303-4707 | 2020-09-15 |
| 1427669746 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1607 Losey Blvd S, La Crosse, WI 54601-6151 | 2020-08-11 |
| 1710598032 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 631 Hometown Cir Ste 106, Verona, WI 53593-1561 | 2020-08-11 |
| 1871138073 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 723 Main Ave, Depere, WI 54115 | 2019-11-12 |
| 1558903815 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 422 Gammon Pl, Madison, WI 53719-1026 | 2019-10-08 |
| 1669013256 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 123 N Mall Dr, Grand Chute, WI 54913-8531 | 2019-10-04 |
| 1952962763 | Martell Eyecare, LLC | Eyewear Supplier (Equipment, not the service) | 703 Third Street, Marathon, WI 54448 | 2019-06-23 |
| 1932767316 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1440 Capital Drive, Suite B, Pewaukee, WI 53072 | 2019-05-31 |
| 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.