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Contact Information

WAL-MART STORE EAST, LP
1330 W. CLEMMNONSVILLE RD.
WINSTON-SALEM, NC27127
 Phone: 336-771-7322
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Eyewear Supplier

332H00000X 87 All Other Suppliers
 

Optician

156FX1800X 96[5] Optician
Indicates primary specialty

NPI Profile & details for WAL-MART STORE EAST, LP

NPI Number 1093870909
LBN Legal business name WAL-MART STORE EAST, LP
Authorized official BJ RICE - (PROVIDER ENROLLMENT SPECIALIST)
Entity Organization
Organization subpart 1 No
Enumeration date 12/22/2006
Last updated 09/11/2025 - About 9 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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