WAL-MART STORES INC (NPI# 1649510082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649510082 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES INC |
| Other Organization Name | WAL-MART VISION CENTER 30-5848 |
| Practice Address |
10075 Bruceville Rd Elk Grove CA 95757-9501 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 9165857809 |
| Practice Fax Number | 9165857602 |
| Mailing Telephone | 4792771240 |
| Mailing Fax Number | 4792774331 |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2013-02-21 |
| Authorized Official Name | MRS. SAMANTHA DAVENPORT (ENROLLMENT SPECIALIST) |
| Authorized Official Telephone | 4792771240 |
| Is Organization Subpart | N |
| 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 30-5848 | 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 |
10075 BRUCEVILLE RD |
| City | ELK GROVE |
| State | CA |
| Zip Code | 95757-9501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356689087 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 10075 Bruceville Rd, Elk Grove, CA 95757-9501 | 2013-01-31 |
| 1437697232 | Woo Optometry, Inc. | Optometrist | 10075 Bruceville Rd, Elk Grove, CA 95757-9501 | 2017-02-01 |
| 1063820389 | Sarah Kim | Pharmacist | 10075 Bruceville Rd, Elk Grove, CA 95757-9501 | 2014-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447896600 | Cassandra Jan Cassas I | Behavior Technician | 9832 Tundra Swan, Elk Grove, CA 95757 | 2019-11-22 |
| 1386287027 | Winslow Dds Inc. | Clinic/Center | 10043 Bruceville Road, Unit 160, Elk Grove, CA 95757 | 2019-10-25 |
| 1386206696 | Daniel & Max, LLC | Optometrist | 7150 Elk Grove Blvd, Elk Grove, CA 95757 | 2019-07-08 |
| 1033684865 | Lua Davidson | Behavioral Analyst | 5504 Aspen Grove Ln, Elk Grove, CA 95757 | 2018-10-08 |
| 1821578386 | Michele Elizabeth Amato | Behavior Technician | 8350 Lotz Parkway, Elk Grove, CA 95757 | 2018-08-15 |
| 1043759632 | Costco Wholesale Corporation | Pharmacy | 7400 Elk Grove Boulevard, Elk Grove, CA 95757 | 2017-02-16 |
| 1497207351 | Ron Dancy | Genetic Counselor, MS | 9864 West Taron Dr, Elk Grove, CA 95757 | 2016-10-26 |
| 1780051524 | Jesselle Pablo | Counselor | 10227 Pedra Do Sol Way, Elk Grove, CA 95757 | 2015-08-27 |
| 1851708945 | Yen Ngoc Hoang | Pharmacist | 8257 Hopewell Drive, Elk Grove, CA 95757 | 2014-07-21 |
| 1477742070 | Nkechi Akudo Nzerem-johnson | Pediatrics | Dignity Health Medical Plaza, 8220 Wymark Drive Suite 200, Elk Grove, CA 95757 | 2007-10-18 |
| Find all providers in zip 95757 | ||||
| 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 |
|---|---|---|---|---|
| 1356863930 | Luxottica Retail North America, Inc | Eyewear Supplier (Equipment, not the service) | 7505 Laguna Blvd, Elk Grove, CA 95758-5061 | 2017-07-14 |
| 1710426200 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 7400 Elk Grove Boulevard, Elk Grove, CA 95757 | 2017-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902488 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 300 E Colorado Blvd Ste 128, Pasadena, CA 91101-2267 | 2020-11-02 |
| 1700485562 | Vision Faire Optometry, Inc. A Professional Optometric Corporation | Eyewear Supplier (Equipment, not the service) | 4213 Dale Rd Ste A-2, Modesto, CA 95356-8505 | 2020-10-22 |
| 1154929859 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 5500 W Sunset Blvd, Los Angeles, CA 90028 | 2020-10-14 |
| 1295333029 | Tiger & Lion Inc | Eyewear Supplier (Equipment, not the service) | 1251 S Beach Blvd Ste F, La Habra, CA 90631-6397 | 2020-10-14 |
| 1245866565 | Joshua Adolfo Velasquez | Eyewear Supplier (Equipment, not the service) | 849 N Ridgewood Pl, Los Angeles, CA 90038-4302 | 2020-03-18 |
| 1952948424 | Luvc LLC | Eyewear Supplier (Equipment, not the service) | 2223 Carlton Ave, Pomona, CA 91768-1015 | 2019-12-04 |
| 1568011377 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 6440 E. Pacific Coast Highway, Space B-165, Long Beach, CA 90803 | 2019-09-05 |
| 1184270746 | Nueyes Technologies Inc | Eyewear Supplier (Equipment, not the service) | 120 Newport Center Dr # 232, Newport Beach, CA 92660-6916 | 2019-08-09 |
| 1881248102 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 12182 1/2 Ventura Blvd, Studio City, CA 91604-2517 | 2019-07-25 |
| 1730732363 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 1628 Redwood Hwy Spc D017, Corte Madera, CA 94925-1248 | 2019-07-23 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on WAL-MART STORES INC.
| 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.