WAL-MART STORES, INC (NPI# 1336223973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336223973 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES, INC |
| Other Organization Name | VISION CENTER 30-2728 |
| Practice Address |
4625 E Maryland St Decatur IL 62521-5092 |
| Mailing Address |
702 Sw 8th St. Bentonville AR 72716-0235 |
| Practice Telephone | 2178646927 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | NICOLE D GENTILE (NPI COORDINATOR) |
| Authorized Official Telephone | 3167885580 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers | ||
| X | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| Vision Center 30-2728 | 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 |
4625 E MARYLAND ST |
| City | DECATUR |
| State | IL |
| Zip Code | 62521-5092 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407873797 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 4625 E Maryland St, Decatur, IL 62521-5092 | 2006-07-16 |
| 1093315830 | Steven Hale Apa Jr. | Pharmacist | 4625 E Maryland St, Decatur, IL 62521-5092 | 2020-10-30 |
| 1336796044 | Alisa Nichols | Pharmacist | 4625 E Maryland St, Decatur, IL 62521-5092 | 2019-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| Find all providers in zip 62521 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427393206 | Vision Plus L.L.C. | Technician/Technologist | 3285 Midway Rd, 113, Decatur, GA 30032-2825 | 2012-12-04 |
| 1952634206 | Luis Felipe Roman | Technician/Technologist | 335 W Ponce De Leon Ave, Suite F, Decatur, GA 30030-2451 | 2009-09-17 |
| 1801916812 | Dan Martin Smyly | Technician/Technologist | 4765 Memorial Dr, Decatur, GA 30032-1417 | 2007-03-31 |
| 1306929955 | Wal-mart Stores, Inc | Technician/Technologist | 4224 N Prospect St, Decatur, IL 62526-6100 | 2006-10-24 |
| 1093896193 | Wal-mart Stores Texas, Lp | Technician/Technologist | 800 S Highway 287, Decatur, TX 76234-1656 | 2006-10-17 |
| 1306217930 | Wal-mart Stores East, Lp | Technician/Technologist | 2525 N Decatur Rd, Decatur, GA 30033-6126 | 2015-10-08 |
| 1801292016 | Otis Weaver | Technician/Technologist | 4765 Memorial Dr, Decatur, GA 30032-1417 | 2014-11-16 |
| 1548489156 | John Marsh | Technician/Technologist | 1756 Candler Rd, Decatur, GA 30032-3277 | 2007-04-24 |
| 1457575680 | Fashion Optique Eyewear, Inc | Technician/Technologist | 2851 Candler Rd, Suite 100, Decatur, GA 30034-1412 | 2007-04-12 |
| 1548350994 | Wal-mart Stores East, Lp | Technician/Technologist | 1700 S 13th St, Decatur, IN 46733-2190 | 2006-10-14 |
| Find all providers in DECATUR | ||||
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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.