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WAL-MART STORES EAST, LP
NPI 1124101852
Eyewear Supplier in Somerset, KY

Active since October 24, 2006CLIA 18D2144984 · Waiver
177 WASHINGTON DR, SOMERSET, KY 42501(606) 679-9204 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

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 1124101852), doing business as Vision Center 30-0689, is a healthcare organization registered as an eyewear supplier in Somerset, Kentucky and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through February 26, 2028 and lists Nicole D Gentile, Npi Coordinator, as its authorized official.

NPPES Registry Identity

NPI1124101852
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameWAL-MART STORES EAST, LP
Location Address177 WASHINGTON DRSomerset, KY 42501-2938
Mailing Address702 Sw 8th St.Bentonville, AR 72716-0235
Phone(606) 679-9204
Organization SubpartNo
Authorized OfficialNicole D GentileNpi Coordinator · (316) 788-5580
Enumeration DateOctober 24, 2006
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1124101852 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
177 WASHINGTON DR, Somerset, KY 42501
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Other Names 1

Doing Business AsVision Center 30-0689

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 ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 18D2144984

Wal-Mart Stores East, LP Dba Wal-Mart Pharmacy #10-689 · Somerset, KY
Active · expires Feb 26, 2028
CLIA Number18D2144984
Laboratory TypePharmacy
Certificate Effective DateFebruary 27, 2026
Certificate Expiration DateFebruary 26, 2028
Laboratory DirectorMr. Aaron K. Bruce
Laboratory Phone(479) 277-1039
Laboratory LocationWal-Mart Stores East, LP Dba Wal-Mart Pharmacy #10-689177 Washington Drive, Somerset, KY 42501
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

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

BRANDI WEDDLE ARNP
Nurse Practitioner
177 WASHINGTON DR
SOMERSET, KY 42501
Pulaski County (859) 260-4385
MEGHAN EALY
Pharmacist
177 WASHINGTON DR
SOMERSET, KY 42501
Pulaski County (606) 679-8466
AMY J WILLIAM
Technician/Technologist (Optician)
177 WASHINGTON DR
SOMERSET, KY 42501
Pulaski County (606) 451-0044
RACHEL MICHELLE HICKS
Technician/Technologist (Optician)
177 WASHINGTON DR
SOMERSET, KY 42501
Pulaski County (606) 451-0044
ERIC ATWELL PHARMD
Pharmacist
177 WASHINGTON DR
SOMERSET, KY 42501
Pulaski County (606) 679-8466
MELISSA BRANSCUM
Technician/Technologist (Optician)
177 WASHINGTON DR
SOMERSET, KY 42501
Pulaski County (606) 451-0044
ASHLEY YOUNG
Technician/Technologist (Optician)
177 WASHINGTON DR
SOMERSET, KY 42501
Pulaski County (606) 451-0044
WAL-MART STORES EAST LP
Pharmacy (Community/Retail Pharmacy)
177 WASHINGTON DR
SOMERSET, KY 42501
Pulaski County (606) 679-8466

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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

The NPI number for Wal-Mart Stores East, LP is 1124101852. It was assigned to this organization in the NPPES registry on October 24, 2006. The provider is doing business as Vision Center 30-0689.

Where is Wal-Mart Stores East, LP located?

Wal-Mart Stores East, LP is located at 177 Washington Dr, Somerset, KY 42501. The listed phone number is (606) 679-9204.

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

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

Does Wal-Mart Stores East, LP hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2144984) is associated with this NPI, valid through February 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Wal-Mart Stores East, LP accept?

Health plans from Blue Cross and Blue Shield of Louisiana list Wal-Mart Stores East, LP as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wal-Mart Stores East, LP was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.