Wal-Mart Stores, Inc

Wal-Mart Stores, Inc is a healthcare organization registered as Eyewear Supplier in Kankakee, IL, holding Type 2 (organization) NPI 1104294065 since 2015. The authorized official on file is Laura Levine, Director.

✓ Active NPI ✓ Valid NPI checksum Organization subpart

NPI	1104294065
Entity type	Organization (Type 2)
Legal business name	Wal-Mart Stores, Inc
Other name	<Unavail>
Parent organization	Wal-Mart Stores, Inc
Practice address	505 RIVERSTONE PKWY, Kankakee, IL, 60901
Phone	4792048550
Fax	4792774331
Enumeration date	2015-09-09
Last updated in NPPES	2015-09-11

Authorized official

Name	Laura Levine
Title	Director
Phone	4792048550

Taxonomy & classification

Taxonomy code	Specialty	Primary	License	State
156FX1800X	Optician	Secondary	—	—
332H00000X	Eyewear Supplier	Primary	—	—

Copy-ready billing details

Provider: Wal-Mart Stores, Inc
NPI: 1104294065
Taxonomy: 332H00000X (Eyewear Supplier)
Address: 505 RIVERSTONE PKWY, Kankakee, IL, 60901

Providers at this address

NPI	Name	Type	Specialty	Location
1386826014	Walmart Inc.	Organization	Community/Retail Pharmacy	Kankakee, IL
1578971560	Richard Fosen	Individual	Pharmacist	Kankakee, IL
1861860470	Walmart	Organization	Community/Retail Pharmacy	Kankakee, IL
1578163457	David Troupe	Individual	Pharmacist	Kankakee, IL
1700487121	Alexis Mcconkey	Individual	Pharmacist	Kankakee, IL

Verify this record

Cross-check NPI 1104294065 against the authoritative CMS record: view Wal-Mart Stores, Inc on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2015-09-11. Verify at npiregistry.cms.hhs.gov.

Where is Wal-Mart Stores, Inc located?

The practice location on file with NPPES is in Kankakee, IL.

Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2015-09-11.