NPI 1063595643

Wal-Mart Stores, INC

Organisation Eyewear Supplier Rockford, IL

Practice location

Address: 3902 W Riverside Blvd, Rockford, IL 61101-9507
Phone: (815) 962-4071
Mailing address: 702 SW 8th St., Bentonville, AR 72716-0235

Authorised official

Name: Nicole D Gentile
Title: Npi Coordinator
Phone: (316) 788-5580

Registered specialties (2)

Eyewear Supplier Primary

Suppliers Taxonomy 332H00000X

Other Eyewear Supplier providers in Illinois →

Optician

Eye and Vision Services Providers Taxonomy 156FX1800X

Other Technician/Technologist providers in Illinois →

Registry record

NPI: 1063595643
Entity type: Organization
NPI issued: 24 Oct 2006
Record last updated: 11 Sep 2025

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.