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General NPI Number Information
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NPI Number | 1588948335
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Entity Type | Organization
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Legal Business Name | WALMART PR INC.
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 09/28/2011
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Provider Practice Location Address
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Address Line | CARR # 1 BO. RIO CANAS PMB 725 BOX 4960
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City | CAGUAS
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State | PR
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Zip | 00726
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Country | US
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Telephone | 787-653-8031
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Fax | 187-798-1206
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Provider Business Mailing Address
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Address Line | CARR # 1 PMB 725 BOX 4960
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City | CAGUAS
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State | PR
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Zip | 00726
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Country | US
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Telephone | 787-653-8031
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Fax | 187-798-1206
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Authorized Official
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Title or Position | RETAIL BUSINESS STRATEGIC DIRECTOR
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Name | MR. RENE PABON
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Credential |
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Telephone | 787-653-8031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State | PR
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