WAL-MART STORES, INC (NPI# 1578647897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578647897 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES, INC |
| Other Organization Name | VISION CENTER 30-2782 |
| Practice Address |
2745 American Legion Blvd Mountain Home ID 83647-3185 |
| Mailing Address |
702 Sw 8th St. Bentonville AR 72716-0235 |
| Practice Telephone | 2085870601 |
| Enumeration Date | 2006-10-24 |
| 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 30-2782 | 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 |
2745 AMERICAN LEGION BLVD |
| City | MOUNTAIN HOME |
| State | ID |
| Zip Code | 83647-3185 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891789368 | Lee James Carter | Optometrist | 2745 American Legion Blvd, Mountain Home, ID 83647-3185 | 2005-09-09 |
| 1467802413 | Joseph Pendleton | Pharmacist | 2745 American Legion Blvd, Mountain Home, ID 83647-3185 | 2016-06-20 |
| 1609220094 | Mischa Pesicek | Pharmacist | 2745 American Legion Blvd, Mountain Home, ID 83647-3185 | 2016-04-21 |
| 1619377959 | Onome Benjamin Jonah | Pharmacist | 2745 American Legion Blvd, Mountain Home, ID 83647-3185 | 2014-08-22 |
| 1548679467 | Donald Toolson | Pharmacist | 2745 American Legion Blvd, Mountain Home, ID 83647-3185 | 2014-08-05 |
| 1891712147 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 2745 American Legion Blvd, Mountain Home, ID 83647-3185 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528684370 | The Unruly Tongue Myofunctional Therapy LLC | Specialist | 1125 Nw Bluegrass Cir, Mountain Home, ID 83647 | 2020-06-17 |
| 1740767284 | Kelly Loy | Counselor | 210 North 3rd East, Mountain Home, ID 83647 | 2018-07-27 |
| 1891247912 | Daelene Sueann Tibbitts | Physical Therapy Assistant | 1665 E 5th N, Mountain Home, ID 83647 | 2016-10-25 |
| 1689065765 | Emma Orthel | Counselor | 2240 American Legion Blvd, Mountain Home, ID 83647 | 2015-02-11 |
| 1073692166 | Krzysztof Hendryk Ziola | Internal Medicine | 2280 American Legion Blvd., Mountain Home, ID 83647 | 2006-11-02 |
| 1952482440 | Michael Peter Koelsch | Internal Medicine | 805 North 6th East, Mountain Home, ID 83647 | 2006-10-18 |
| 1124113709 | Talmage W Delange | Counselor | 235 North 3rd East, Mountain Home, ID 83647 | 2006-10-03 |
| 1225044019 | Scott W Sessions | Physical Therapist | 245 N. 3rd, Mountain Home, ID 83647 | 2006-07-31 |
| 1750370730 | Kyle J Kenison | Optometrist | 855 West 6th South, Mountain Home, ID 83647 | 2005-10-21 |
| 1285628156 | Bruce Joseph Siedlecki | Obstetrics & Gynecology | Mtn.home Aif Force Base, Mdos, Mtn. Home, ID 83647 | 2005-09-07 |
| Find all providers in zip 83647 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912080466 | Wal-mart Stores, Inc. | Technician/Technologist | 65 Wal Mart Dr, Mountain Home, AR 72653-6784 | 2006-10-20 |
| 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 | ||||
| City | MOUNTAIN HOME |
| Zip Code | 83647 |
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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.