OrganizationActive
Wal-Mart Stores East, Lp.
NPI 1205603453 · Optician · Woodland, CA
Wal-Mart Stores East, Lp. is a Optician organization in Woodland, CA (NPI 1205603453).
Provider details
- NPI number
- 1205603453
- Entity type
- Organization
- Primary specialty
- OpticianEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Kimberly Canonic, Sr Director(479) 371-1168
Specialties & taxonomies
Eye and Vision Services Providers
- Eyewear Supplier332H00000X
Suppliers
Profile Score
Established profile(57/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1720 E Main St
Woodland, CA 95776-6223
Phone: (530) 668-1457
Street-level locationGet directions
Mailing address
1 Customer Dr, Ms 0445
Bentonville, AR 72716-0445
Other names (DBA / former)
- Doing business as
- Walmart Pharmacy 10-3164
Registry dates
- Enumerated
- 2023-12-07
- Last updated
- 2025-10-02
- Certified
- 2025-10-02
Frequently asked questions
- What is Wal-Mart Stores East, Lp.'s NPI number?
- Wal-Mart Stores East, Lp.'s National Provider Identifier (NPI) is 1205603453, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Wal-Mart Stores East, Lp.?
- Wal-Mart Stores East, Lp. is classified in the NPPES registry as Optician (Eye and Vision Services Providers).
- Where is Wal-Mart Stores East, Lp. located?
- Wal-Mart Stores East, Lp.'s practice location on file with NPPES is 1720 E Main St, Woodland, CA 95776-6223.
- What is Wal-Mart Stores East, Lp.'s phone number?
- The practice phone number listed in the NPPES registry for Wal-Mart Stores East, Lp. is (530) 668-1457.
- Who is the authorized official for Wal-Mart Stores East, Lp.?
- The authorized official listed on Wal-Mart Stores East, Lp.'s NPPES record is Kimberly Canonic, Sr Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Wal-Mart Stores East, Lp.'s NPI active?
- Yes — Wal-Mart Stores East, Lp.'s NPI (1205603453) is active in the NPPES registry as of the last update on 2025-10-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.