Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

WAL-MART STORES EAST LP
NPI 1093000168
Eyewear Supplier in King George, VA

Q: What is Wal-Mart Stores East LP's NPI number?

The NPI number for Wal-Mart Stores East LP is 1093000168. It was assigned to this organization in the NPPES registry on June 16, 2011. The provider is doing business as Vision Center 30-5779 and Walmart Vision Center 30-5779.

Q: What is Wal-Mart Stores East LP's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

Active since June 16, 2011

16375 MERCHANTS LN, KING GEORGE, VA 22485(540) 413-3141(540) 644-0719 Get Directions Write a Review

NPPES record last updated: August 27, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

On this page

About Wal-mart Stores East Lp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WAL-MART STORES EAST LP (NPI 1093000168), doing business as Vision Center 30-5779, is a healthcare organization registered as an eyewear supplier in King George, Virginia and active in the NPI registry since June 2011. The organization lists Kimberly Canonic, Senior Director, as its authorized official.

NPPES Registry Identity

NPI1093000168

Entity TypeOrganization

Primary Taxonomy332H00000X

Legal Business NameWAL-MART STORES EAST LP

Location Address16375 MERCHANTS LNKing George, VA 22485-5655

Mailing Address1 Customer Drive, Ms 0445Bentonville, AR 72716-0445

Phone(540) 413-3141

Fax(540) 644-0719

Organization SubpartYesParent: Wal-mart Stores Inc

Authorized OfficialKimberly CanonicSenior Director · (480) 853-0515

Enumeration DateJune 16, 2011

Last NPPES UpdateAugust 27, 2026

NPPES CertifiedAugust 27, 2026

✔ NPI 1093000168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEyewear SupplierSuppliers

Taxonomy Code332H00000X

Definition

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Also ListedTechnician/Technologist · OpticianTaxonomy 156FX1800X

16375 MERCHANTS LN, King George, VA 22485

Open in Google Maps ↗

Other Names 2

Doing Business AsVision Center 30-5779

Doing Business AsWalmart Vision Center 30-5779

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana.Insurance ›

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER ELLEN CROSSMAN LDO

Technician/Technologist (Optician)