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Contact Information

WAL-MART STORES EAST, LP
724 STADIUM W. BLVD.
JEFFERSON CITY, MO65109
 Phone: 573-635-8283
 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 STORES EAST, LP

NPI # 1306927488
LBN Legal business name WAL-MART STORES EAST, LP
Authorized official NICOLE GENTILE - (NPI COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/17/2006
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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