DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: WAL-MART STORES EAST, LP

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
1156FX1800XOptician
2332H00000XEyewear Supplier

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326130519
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 : 8550 N DALE MABRY HWY
Second Line :
City : TAMPA
State : FL
Zip : 33614-1646
Country : US
Telephone Number : 813-887-5175
Fax Number :
Authorized Official
Title or Position : NPI COORDINATOR
Name : NICOLE D GENTILE
Credential :
Telephone Number : 316-788-5580
Provider Enumeration Date : 09/28/2006
Last Update Date : 09/11/2025

Similar Medicare Providers

1770413445 — AETHERUS WOUND AND LYMPHATICS PLLC
Practice Location Address:
15310 AMBERLY DR STE 195
TAMPA, FL
33647-1646
Practice Phone: 813-212-6517
Practice Fax:
1205895604 — DR. KEVIN BARRIDO O.D.
Practice Location Address:
15835 N DALE MABRY HWY
TAMPA, FL
33618-1646
Practice Phone: 813-269-9883
Practice Fax:
1013934405 — SAMS EAST INC
Practice Location Address:
15835 N DALE MABRY HWY
TAMPA, FL
33618-1646
Practice Phone: 813-269-4764
Practice Fax:
1376641365 — SAM'S CLUB OPTICAL
Practice Location Address:
15835 N DALE MABRY HWY
TAMPA, FL
33618-1646
Practice Phone: 813-960-2110
Practice Fax:
1851695357 — DR KEVIN K BARRIDO OD PA
Practice Location Address:
15835 N DALE MABRY HWY
TAMPA, FL
33618-1646
Practice Phone: 813-269-9883
Practice Fax:
1205204237 — HIEP PHAM PHARMD
Practice Location Address:
15835 N DALE MABRY HWY
TAMPA, FL
33618-1646
Practice Phone: 813-269-4764
Practice Fax:

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.