WAL-MART STORES, INC. (NPI# 1639502842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639502842 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES, INC. |
| Other Organization Name | WAL-MART PHARMACY 30-5976 |
| Practice Address |
11505 Ulysses St Ne Blaine MN 55434-4239 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 7633545402 |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2013-08-20 |
| Authorized Official Name | MRS. LAURA LEVINE (MANAGER OF GOVERNMENT CONTRACTING) |
| 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 Pharmacy 30-5976 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164955852 | Wal-mart Stores, Inc. | Eyewear Supplier (Equipment, not the service) | 9400 Ralston Road, Arvada, CO 80002 | 2017-04-10 |
| 1780039115 | Wal-mart Stores, Inc. | Technician/Technologist | 365 Lake Marian Road, Carpentersville, IL 60110 | 2016-05-04 |
| 1891149332 | Wal-mart Stores, Inc. | Technician/Technologist | 22401 Central Avenue, Richton Park, IL 60471 | 2016-04-21 |
| 1629436233 | Wal-mart Stores, Inc. | Technician/Technologist | 1301 N Victory Pl, Burbank, CA 91502-1649 | 2016-02-10 |
| 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 |
| 1760882666 | Wal-mart Stores, Inc. | Technician/Technologist | 82-491 Avenue 42, Indio, CA 92203 | 2014-08-27 |
| 1568879419 | Wal-mart Stores, Inc. | Technician/Technologist | 5200 W 60th Street N, Sioux Falls, SD 57107-6504 | 2014-07-11 |
| 1508283730 | Wal-mart Stores, Inc. | Technician/Technologist | 1424 Highway 2 E, Devils Lake, ND 58301-4000 | 2014-03-26 |
| 1396169041 | Wal-mart Stores, Inc. | Technician/Technologist | 2552 W. 75th Street, Naperville, IL 60540-0000 | 2014-02-14 |
| 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 |
| Street Address |
11505 ULYSSES ST NE |
| City | BLAINE |
| State | MN |
| Zip Code | 55434-4239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205273984 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 11505 Ulysses St Ne, Blaine, MN 55434-4239 | 2013-06-04 |
| 1134727803 | Krystal Sievert | Pharmacist | 11505 Ulysses St Ne, Blaine, MN 55434-4239 | 2020-10-14 |
| 1215535273 | Kyle Loftus | Pharmacist | 11505 Ulysses St Ne, Blaine, MN 55434-4239 | 2020-10-13 |
| 1417555335 | Joshua Dehn | Pharmacist | 11505 Ulysses St Ne, Blaine, MN 55434-4239 | 2020-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023628591 | Rahul Farmah | Optometrist | 680 Hwy 10 Ne, Blaine, MN 55434 | 2020-08-08 |
| 1033770714 | Enduring Home Health Care Corp | Home Health | 10812 Fillmore Street, Blaine, MN 55434 | 2019-06-24 |
| 1932762408 | Vital Agency LLC | In Home Supportive Care | 12864 Fillmore Street Ne, Blaine, MN 55434 | 2019-04-19 |
| 1548751654 | Dustin Adam Kakach | Pharmacist | 600 County Hwy 10, Blaine, MN 55434 | 2018-05-24 |
| 1598253445 | Jacob James Apland | Behavioral Analyst | 12401 Oak Park Blvd Ne Apt 316, Blaine, MN 55434 | 2018-04-26 |
| 1962921924 | Mw Minnetonka Operating LLC | Assisted Living Facility | 1005 Paul Parkway Ne, Blaine, MN 55434 | 2017-09-11 |
| 1922526961 | Blaine Asc, LLC | Clinic/Center | 11225 Ulysses Street Northeast, Blaine, MN 55434 | 2017-08-30 |
| 1629591334 | Minnehaha Transportation Inc | Non-emergency Medical Transport (VAN) | 2507 Walnut St, Roseville, MN 55434 | 2017-07-25 |
| 1629590872 | Alexandra Staum Reif | Pediatrics | 11107 Ulysses Street Ne, Suite 100, Blaine, MN 55434 | 2017-07-10 |
| 1962939546 | Nicolette Gengel | Dentist | 1384 109th Ave Ne Ste 200, Blaine, MN 55434 | 2017-05-15 |
| Find all providers in zip 55434 | ||||
| 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 |
|---|---|---|---|---|
| 1457860702 | Visionpros Usa Inc | Eyewear Supplier (Equipment, not the service) | 1750 Grant Ave, Blaine, WA 98230-5155 | 2017-09-28 |
| 1306042817 | North Suburban Optical | Eyewear Supplier (Equipment, not the service) | 11855 Ulysses St, Suite 140, Blaine, MN 55434 | 2007-06-22 |
| 1356426761 | Vision World Inc | Eyewear Supplier (Equipment, not the service) | 125 Northtown Drive, Blaine, MN 55434 | 2006-10-25 |
| 1912332271 | Tec LLC | Eyewear Supplier (Equipment, not the service) | 10961 Club West Pkwy, Suite 130, Blaine, MN 55449-5866 | 2013-09-05 |
| 1104103894 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 125 Northtown Dr Ne, Blaine, MN 55434-1036 | 2011-11-08 |
| 1508911496 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 260 Northtown Dr Ne, Blaine, MN 55434 | 2007-01-24 |
| 1457403990 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 1500 109th Ave Ne, Blaine, MN 55449-4670 | 2007-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493903 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 11995 Business Park Blvd N, Champlin, MN 55316 | 2020-10-02 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1891351268 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1101 E College Dr, Marshall, MN 56258-2366 | 2019-05-11 |
| 1730745100 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1459 W Service Dr, Winona, MN 55987-2512 | 2019-05-11 |
| 1649836016 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1023 E Blue Earth Ave, Fairmont, MN 56031-4076 | 2019-05-11 |
| 1124684592 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1004 18th Ave Nw Ste D, Austin, MN 55912-1993 | 2019-05-11 |
| 1053977421 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1620 Broadway Ave S Ste 4, Rochester, MN 55904-7927 | 2019-05-11 |
| 1942866371 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 4051 W Division St Ste A, Saint Cloud, MN 56301-3741 | 2019-05-10 |
| 1831651165 | Don Sealock, O.d., P.a. | Eyewear Supplier (Equipment, not the service) | 3366 Oakdale Ave N Ste 140, Robbinsdale, MN 55422-2961 | 2019-04-04 |
| 1538624341 | Don Sealock, O.d., P.a. | Eyewear Supplier (Equipment, not the service) | 9825 Hospital Dr # 106, Maple Grove, MN 55369-4479 | 2019-02-06 |
| 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.