NPI 1003964776
Wal-Mart Stores, INC
Practice location
- Address
- 440 Wadsworth Blvd, Lakewood, CO 80226-1510
- Phone
- (303) 205-0772
- Fax
- (303) 205-0774
- Mailing address
- 702 SW 8th Street, Bentonville, AR 72716-0235
Authorised official
- Name
- G Wesley Crainshaw
- Title
- Provider Enrollment Specialist
- Phone
- (479) 277-1850
Registered specialties (2)
Optician
Primary
Eyewear Supplier
Registry record
- NPI
- 1003964776
- Entity type
- Organization
- NPI issued
- 8 Jan 2007
- Record last updated
- 13 Sep 2007
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.