Organization Name: | WAL-MART STORES, INC. |
NPI Number: | 1194194605 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEB LAUVER (SPECIALIST PLAN ENEOLLMENT) |
Mailing Address: | 6403 W Pointe Pkwy Post Falls |
State: | ID US |
Postal Code: | 838545517 |
Phone Number: | 2086185034 |
Fax Number: | 2084571717 |
NPI Enumeration Date: | 09/15/2015 |
NPI Last Update Date: | 10/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |