MEDICARE: WAL-MART STORES EAST, LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician
2	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1215010145
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAL-MART STORES EAST, LP

Provider Business Mailing Address
First Line	:	702 SW 8TH ST.
Second Line	:
City	:	BENTONVILLE
State	:	AR
Zip	:	72716-0235
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 HIGHWAY 431 N
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-2362
Country	:	US
Telephone Number	:	334-291-1700
Fax Number	:

Authorized Official
Title or Position	:	NPI COORDINATOR
Name	:	NICOLE D GENTILE
Credential	:
Telephone Number	:	316-788-5580

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	09/11/2025

Similar Medicare Providers

1871511394 — WAL-MART STORES EAST LP
Practice Location Address:

3700 US HIGHWAY 431 N
PHENIX CITY, AL
36867-2362

Practice Phone: 334-291-1814
Practice Fax:

1467559088 — DR. JONATHAN GUY HARP O.D.
Practice Location Address:

3700 HIGHWAY 431 N
PHENIX CITY, AL
36867-2362

Practice Phone: 334-291-6379
Practice Fax: 334-291-9109

1659125177 — DR. EVETTE RANSAW BS, MS, DDS
Practice Location Address:

3732 US HIGHWAY 431 N
PHENIX CITY, AL
36867-2362

Practice Phone: 334-408-3467
Practice Fax:

1518896331 — STEPHANIE ROSEMARIE PITTARO
Practice Location Address:

2911 SUMMIT AVE
UNION CITY, NJ
07087-2362

Practice Phone: 201-972-5739
Practice Fax:

1629924931 — ESSEX THERAPY, LLC
Practice Location Address:

2911 SUMMIT AVE
UNION CITY, NJ
07087-2362

Practice Phone: 201-290-8326
Practice Fax:

1659539633 — DR. HOLGER G ARMAS M.D.
Practice Location Address:

2911 SUMMIT AVE , SUITE 105
UNION CITY, NJ
07087-2362

Practice Phone: 201-558-7816
Practice Fax: 201-223-5745

Directions to “WAL-MART STORES EAST, LP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.