WAL-MART STORES, INC (NPI# 1417032715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417032715 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES, INC |
| Other Organization Name | VISION CENTER 30-5199 |
| Practice Address |
475 E. Route 173 Antioch IL 60002 |
| Mailing Address |
702 Sw 8th St. Bentonville AR 72716-0235 |
| Practice Telephone | 8478382148 |
| Enumeration Date | 2006-10-26 |
| 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 30-5199 | 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 |
475 E. ROUTE 173 |
| City | ANTIOCH |
| State | IL |
| Zip Code | 60002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821620345 | Kathleen Ann Bleyaert | Technician | 24238 W. Bayview Rd, Antioch, IL 60002 | 2020-02-12 |
| 1992354385 | Pauravi Hefner | Developmental Therapist | 270 Hickory Lane, Antioch, IL 60002 | 2019-09-09 |
| 1689023558 | Shannon Marie Herman | Pharmacist | 966 Route 59, Antioch, IL 60002 | 2016-06-10 |
| 1992151856 | Suchitra Gosavi | Physical Therapist | 3703west Lake Ave, Suit 200, Glenview, IL 60002 | 2016-05-10 |
| 1336513357 | Athletico Ltd | Physical Therapist | 1122 Main St., Antioch, IL 60002 | 2015-11-16 |
| 1811306335 | Jennifer Fitzgerald | Massage Therapist | 673 Cameron Drive, Antioch, IL 60002 | 2014-08-08 |
| 1114262052 | Michael W Silenzi | Physical Therapist | 543 Orchard Str, Antioch, IL 60002 | 2012-12-04 |
| 1659561678 | Expert Home Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 40225 N Rt 83, Suite B, Antioch, IL 60002 | 2007-07-26 |
| 1821157769 | Robert T Sven,dds,ltd | Dentist | 439 Lake Street, Antioch, IL 60002 | 2006-12-06 |
| 1447326004 | Stanley Jerome Witkiewicz | Dentist | 715 N Main, Antioch, IL 60002 | 2006-11-27 |
| Find all providers in zip 60002 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063530210 | Profluent Systems Inc | Technician/Technologist | 5887 Lone Tree Way Ste M, Antioch, CA 94531-8625 | 2007-03-27 |
| 1568557130 | Wesval Enterprises Inc | Technician/Technologist | 3714 Lone Tree Way, Antioch, CA 94509 | 2006-10-03 |
| 1376183012 | Gregory Vallejo | Technician/Technologist | 3714 Lone Tree Way, Antioch, CA 94509-6018 | 2020-01-10 |
| 1376628966 | Wal-mart Stores East, Lp | Technician/Technologist | 3035 Hamilton Church Rd, Antioch, TN 37013-1429 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902445570 | Kami Optical Corp | Technician/Technologist | 1163 E Ogden Ave Ste 701, Naperville, IL 60563-8535 | 2019-12-31 |
| 1750847281 | National Vision Inc | Technician/Technologist | 750 S Rand Rd, Lake Zurich, IL 60047-2467 | 2019-02-20 |
| 1700364171 | National Vision Inc | Technician/Technologist | 4068 North Milwaukee Avenue, Chicago, IL 60641 | 2018-07-30 |
| 1720571615 | National Vision, Inc. | Technician/Technologist | 6931 Grand Ave Ste E2, Gurnee, IL 60031-1610 | 2018-06-14 |
| 1023528619 | Direct Healthcare Solutions LLC | Technician/Technologist | 1520 Fringetree Ln, Woodridge, IL 60517-4653 | 2017-10-09 |
| 1184140014 | Efp Opticians On Dearborn, LLC | Technician/Technologist | 1205 N Dearborn St, Chicago, IL 60610-2213 | 2017-08-22 |
| 1235668245 | Vision Man | Technician/Technologist | 8335 Grand Ave, River Grove, IL 60171-1434 | 2017-06-05 |
| 1033662200 | National Vision, Inc. | Technician/Technologist | 348 W Army Trail Rd, Suite 130, Bloomingdale, IL 60108-5608 | 2016-07-25 |
| 1780039115 | Wal-mart Stores, Inc. | Technician/Technologist | 365 Lake Marian Road, Carpentersville, IL 60110 | 2016-05-04 |
| 1346695392 | National Vision, Inc. | Technician/Technologist | 714 S Randall Rd, Algonquin, IL 60102-5915 | 2016-04-27 |
| Find all providers with the same taxonomy | ||||
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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.