WAL-MART STORES INC (NPI# 1710221023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710221023 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES INC |
| Other Organization Name | WAL-MART VISION CENTER30-3102 |
| Practice Address |
300 21st Ave N Princeton MN 55371 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 7633891561 |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2012-11-27 |
| Authorized Official Name | AMY POWERS (SPECIALIST, PLAN ENROLLMENT) |
| Authorized Official Telephone | 4792040709 |
| 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 Center30-3102 | 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 |
300 21ST AVE N |
| City | PRINCETON |
| State | MN |
| Zip Code | 55371 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043554504 | Walmart Inc. | Pharmacy | 300 21st Ave N, Princeton, MN 55371-6271 | 2012-11-21 |
| 1982203923 | Chelsea Rae Brezinka | Pharmacist | 300 21st Ave N, Princeton, MN 55371-6271 | 2020-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053962530 | Monica Gail Broten | Technician | 30840 Tiger Street Nw, Princeton, MN 55371 | 2019-09-25 |
| 1215349584 | Stephen Destefano | Pharmacist | 31419 131st Street, Princeton, MN 55371 | 2014-05-21 |
| 1164798948 | Andrew Sudbeck | Counselor | 101 18th Avenue North, Princeton, MN 55371 | 2012-03-27 |
| 1073804803 | Sterling Pointe Senior Living LLC | Assisted Living Facility | 1250 Northland Drive, Princeton, MN 55371 | 2011-04-27 |
| 1568752533 | Rum River Health Services, Inc. | Substance Abuse Rehabilitation Facility | 3079 90th Avenue, Princeton, MN 55371 | 2011-04-12 |
| 1780989038 | Dr. Kynan Westermeyer, Dds, Pllc | Clinic/Center | 404 1st St. N, Princeton, MN 55371 | 2011-01-18 |
| 1275788085 | Cody James Leff | Pharmacist | 1100 11th Avenue South, Princeton, MN 55371 | 2008-11-20 |
| 1164679213 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1101 N 5th St, Princeton, MN 55371 | 2008-08-20 |
| 1801059639 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1506 1st Street, Princeton, MN 55371 | 2008-07-02 |
| 1497940928 | James Michael Mandt | Pharmacist | 911 Northland Drive, Fairview Northland Medical Center, Princeton, MN 55371 | 2007-09-07 |
| Find all providers in zip 55371 | ||||
| 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 |
|---|---|---|---|---|
| 1225194475 | Thomas L Nunnelee Inc | Eyewear Supplier (Equipment, not the service) | 900 Rum River Dr South, Suite 103, Princeton, MN 55371 | 2006-12-29 |
| 1558309443 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 101 Nassau Park Blvd, Princeton, NJ 08540-5918 | 2006-06-03 |
| 1881149227 | Princeton Eye Group, Pa | Eyewear Supplier (Equipment, not the service) | 419 N Harrison St, Princeton, NJ 08540-3521 | 2016-08-15 |
| 1477722171 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 2700 W Broadway St, Princeton, IN 47670-9418 | 2008-02-27 |
| 1194879205 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 3535 Us Highway 1, Princeton, NJ 08540 | 2007-01-23 |
| 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.