WAL-MART STORES, INC (NPI# 1932570348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932570348 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES, INC |
| Other Organization Name | WALMART VISION CENTER 30-5763 |
| Practice Address |
3590 W South Jordan Pkwy South Jordan UT 84095-8916 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 4792582115 |
| Practice Fax Number | 4792774331 |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2015-10-12 |
| Authorized Official Name | DEB LAUVER (SPECIALIST PLAN ENROLLMENT) |
| Authorized Official Telephone | 4792582115 |
| 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 |
|---|---|
| Walmart Vision Center 30-5763 | 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 |
| Street Address |
3590 W SOUTH JORDAN PKWY |
| City | SOUTH JORDAN |
| State | UT |
| Zip Code | 84095-8916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689912594 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 3590 W South Jordan Pkwy, South Jordan, UT 84095-8916 | 2013-01-28 |
| 1932700747 | Nicole Crockett | Pharmacist | 3590 W South Jordan Pkwy, South Jordan, UT 84095-8916 | 2020-11-06 |
| 1003417890 | Kyle Crutcher | Pharmacist | 3590 W South Jordan Pkwy, South Jordan, UT 84095-8916 | 2020-11-06 |
| 1992306302 | Brent Hiramoto | Pharmacist | 3590 W South Jordan Pkwy, South Jordan, UT 84095-8916 | 2020-11-03 |
| 1346608619 | Slc Walmart Eye Docs | Optometrist | 3590 W South Jordan Pkwy, South Jordan, UT 84095-8916 | 2016-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033745393 | Beverly Laraine Williams | Social Worker | 11260 S River Heights Drive, South Jordan, UT 84095 | 2020-03-19 |
| 1265902902 | Sarah Richele Kelley | Specialist/Technologist | 10236 Alder Grovey Way, South Jordan, UT 84095 | 2018-11-26 |
| 1326528837 | Kristi Couse | Massage Therapist | 10679 S 2200 W Apt 2, South Jordan, UT 84095 | 2018-08-15 |
| 1821516063 | River Crossing Dental Professional Corporation | Clinic/Center | 12427 South 4000 West, Suite #200, Riverton, UT 84095 | 2017-09-08 |
| 1245755719 | Staci Stout | Dental Hygienist | 3113 W Swiss Pass Cir, South Jordan, UT 84095 | 2017-08-07 |
| 1437698750 | Ryan Sears | Dentist | 10894 So. River Front Parkway, South Jordan, UT 84095 | 2017-02-20 |
| 1366989931 | Ultimate Sports Regenerative Medicine | Chiropractor | 1098 W. South Jordan Pkwy, Suite 101, South Jordan, UT 84095 | 2017-01-20 |
| 1306393889 | Tal Quirl | Optometrist | 3571 W. 10400 S., South Jordan, UT 84095 | 2016-09-01 |
| 1023562667 | Sevon Taroian | Social Worker | 11260 River Heights Drive, South Jordan, UT 84095 | 2016-08-11 |
| 1952762932 | Megan Buckley | Developmental Therapist | 881 Baxter Drive, Ste 100, South Jordan, UT 84095 | 2016-03-17 |
| Find all providers in zip 84095 | ||||
| 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 |
|---|---|---|---|---|
| 1841681384 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 3571 W 10400 S, South Jordan, UT 84095 | 2015-02-05 |
| 1184886913 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 11278 South Jordan Gtwy, South Jordan, UT 84095 | 2008-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935882 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 15 S River Rd # 150, St George, UT 84790-2106 | 2020-06-08 |
| 1265088074 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 846 Expressway Ln, Spanish Fork, UT 84660-1300 | 2019-08-16 |
| 1407412885 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1520 W 9000 S Ste E, West Jordan, UT 84088-8001 | 2019-05-11 |
| 1043876428 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2843 S 5600 W Ste 170, West Valley City, UT 84120-6089 | 2019-05-11 |
| 1134785512 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2035 Harris Blvd Ste C, Layton, UT 84041-1655 | 2019-05-11 |
| 1124584529 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 1986 N Hill Field Rd Ste 5, Layton, UT 84041-2112 | 2019-02-11 |
| 1003383803 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 918 E 900 S, Salt Lake City, UT 84105-1402 | 2018-10-30 |
| 1356826010 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 4115 Riverdale Rd, Ogden, UT 84405-3509 | 2018-09-28 |
| 1003398025 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 366 E University Pkwy, Orem, UT 84058 | 2018-09-06 |
| 1790225696 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 6117 S State St, Murray, UT 84107-7343 | 2017-02-27 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH JORDAN |
| Zip Code | 84095 |
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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.