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WAL-MART STORES EAST, LP
NPI 1477667400
Eyewear Supplier in Youngstown, OH

Active since August 18, 2006CLIA 36D2121894 · Waiver
1300 DORAL DR, YOUNGSTOWN, OH 44514(330) 758-0011 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 23, 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 1477667400), doing business as Vision Center 30-2211, is a healthcare organization registered as an eyewear supplier in Youngstown, Ohio and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through November 15, 2026 and lists Tammy J Boyd, Contract Coordinator, as its authorized official.

NPPES Registry Identity

NPI1477667400
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameWAL-MART STORES EAST, LP
Location Address1300 DORAL DRYoungstown, OH 44514-1900
Mailing Address702 Sw 8th StBentonville, AR 72716-6209
Phone(330) 758-0011
Organization SubpartNo
Authorized OfficialTammy J BoydContract Coordinator · (479) 277-1359
Enumeration DateAugust 18, 2006
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1477667400 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
1300 DORAL DR, Youngstown, OH 44514
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Other Names 1

Doing Business AsVision Center 30-2211

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 36D2121894

Wal-Mart Stores East, LP Dba Wal-Mart Pharmacy #10-2211 · Poland, OH
Active · expires Nov 15, 2026
CLIA Number36D2121894
Laboratory TypePharmacy
Certificate Effective DateNovember 16, 2024
Certificate Expiration DateNovember 15, 2026
Laboratory DirectorCynthia Johnson Rph
Laboratory Phone(479) 258-7034
Laboratory LocationWal-Mart Stores East, LP Dba Wal-Mart Pharmacy #10-22111300 Doral Drive, Poland, OH 44514
CLIA data matches this NPI record on: 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.

GEORGEANN NOBLE
Technician/Technologist (Optician)
1300 DORAL DR
POLAND, OH 44514
Mahoning County (330) 758-0708
DAN J KULIFAY II
Technician/Technologist (Optician)
1300 DORAL DR
POLAND, OH 44514
Mahoning County (330) 758-0708
CYNTHIA JOHNSON RPH
Pharmacist
1300 DORAL DR
POLAND, OH 44514
Mahoning County (330) 758-0040
DR. ROBERT DRAY III PHARM. D
Pharmacist
1300 DORAL DR
POLAND, OH 44514
Mahoning County (330) 758-0040
KIMBERLY RESTAINO RPH
Pharmacist
1300 DORAL DR
YOUNGSTOWN, OH 44514
Mahoning County (330) 758-0040
WAL-MART STORES EAST LP
Pharmacy (Community/Retail Pharmacy)
1300 DORAL DR
POLAND, OH 44514
Mahoning County (330) 758-0040
KELLY SWANSON PHARMD
Pharmacist
1300 DORAL DR
POLAND, OH 44514
Mahoning County (330) 758-0040
JENNIFER DIANE GLISTA
Technician/Technologist (Optician)
1300 DORAL DR
POLAND, OH 44514
Mahoning County (330) 758-0708

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 1477667400. It was assigned to this organization in the NPPES registry on August 18, 2006. The provider is doing business as Vision Center 30-2211.

Where is Wal-Mart Stores East, LP located?

Wal-Mart Stores East, LP is located at 1300 Doral Dr, Youngstown, OH 44514. The listed phone number is (330) 758-0011.

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 36D2121894) is associated with this NPI, valid through November 15, 2026. 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 11 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.