SAM'S CLUB OPTICAL (NPI# 1033208616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033208616 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6621 |
| Practice Address |
904 Pleasant Grove Blvd Roseville CA 95678-6126 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 9167818160 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LINDA M. EPPERSON (NPI COORDINATOR) |
| Authorized Official Telephone | 3167885580 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers | ||
| X | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| Sam's Club Optical 30-6621 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881924413 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 4420 King Avenue East, Billings, MT 59101 | 2010-01-04 |
| 1457589111 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 450 Townsend Road, Cocoa, FL 32926 | 2009-07-01 |
| 1427286251 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 745 W El Camino Alto Drive, Springfield (s), MO 65810 | 2009-07-01 |
| 1093951956 | Sam's Club Optical | Technician/Technologist | 755 N. Hwy 27/441, Lady Lake (the Villages), FL 32159 | 2008-12-24 |
| 1619125903 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 3247 23rd Avenue, Evans, CO 80620 | 2008-08-29 |
| 1720236011 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 2000 Clements Bridge Rd Ste 116, Deptford, NJ 08096-2011 | 2008-08-29 |
| 1184886913 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 11278 South Jordan Gtwy, South Jordan, UT 84095 | 2008-07-02 |
| 1356516116 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 3839 Mundy Mill Road, Oakwood, GA 30566 | 2008-04-23 |
| 1104095801 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 7100 West Arroyo Crossing Pkwy, Las Vegas, NV 89113 | 2008-02-27 |
| 1114101193 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 2650 East Craig Road, North Las Vegas, NV 89030 | 2007-12-26 |
| Street Address |
904 PLEASANT GROVE BLVD |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95678-6126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538186762 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 904 Pleasant Grove Blvd, Roseville, CA 95678-6126 | 2006-07-16 |
| 1437567450 | Luan Huynh | Pharmacist | 904 Pleasant Grove Blvd, Roseville, CA 95678-6126 | 2014-07-23 |
| 1073920088 | Jagdeep Girn | Pharmacist | 904 Pleasant Grove Blvd, Roseville, CA 95678-6126 | 2014-07-22 |
| 1588847974 | Firstsight Vision Services, Inc. | Optometrist | 904 Pleasant Grove Blvd, Roseville, CA 95678-6126 | 2007-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114533064 | Alexander V. Antipov, D.d.s., Inc. | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678 | 2020-09-16 |
| 1396378980 | David F Shirley M D P C | Family Medicine | 4001 Impala Circle, Roseville, CA 95678 | 2020-02-21 |
| 1083256051 | Rosemary Ellen Robben | Community Health Worker | Cirby Wellness Center 101 Cirby Hills Drive, Roseville, CA 95678 | 2019-10-11 |
| 1588217236 | Kaiser Foundation Health Plan Inc | Pharmacy | 1021 Riverside Ave, Roseville, CA 95678 | 2019-07-22 |
| 1174093793 | Neftali Hernandez | Behavior Technician | 1100 Roseville Parkway Apt 1021, Roseville, CA 95678 | 2018-11-26 |
| 1467951798 | Amarantha Martinez | Behavior Technician | 1900 Quail Ridge Road, #99, Roseville, CA 95678 | 2018-02-01 |
| 1093231276 | Compassionate Home Health, Ltd | Home Health | 1100 Melody Lane, Suite 106, Roseville, CA 95678 | 2017-08-18 |
| 1629598891 | Jimena Andrade Martins | Behavior Technician | 602 Atkinson Street, Roseville, CA 95678 | 2017-06-20 |
| 1891221057 | Zride Inc | Taxi | 106 Church Street, Suite 2, Roseville, CA 95678 | 2017-05-10 |
| 1568997641 | Joline Trinh | Pharmacist | 1030 Pleasant Grove Boulevard, Roseville, CA 95678 | 2017-04-26 |
| Find all providers in zip 95678 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649717489 | National Vision, Inc. | Technician/Technologist | 1010 Pleasant Grove Blvd, Suite 120, Roseville, CA 95678-6118 | 2017-01-31 |
| 1124411491 | W Optical 3 LLC | Technician/Technologist | 31503 Gratiot Ave, Roseville, MI 48066-4583 | 2015-03-11 |
| 1902227689 | Eyeglass World | Technician/Technologist | 31873 Gratiot Ave, Roseville, MI 48066-4527 | 2013-12-23 |
| 1558545582 | Gorman Optical Inc | Technician/Technologist | 2797 Hamline Ave No, Hamline Center Suite 2, Roseville, MN 55113-1715 | 2007-12-27 |
| 1538355102 | America's Best Contacts & Eyeglasses | Technician/Technologist | 29138 Gratiot Ave, Roseville, MI 48066-4152 | 2007-09-18 |
| 1366645285 | Roseville Site for Vision Products, Inc. | Technician/Technologist | 1095 Roseville Sq, Roseville, CA 95678-2809 | 2007-06-07 |
| 1659407377 | Juettner Optical Inc | Technician/Technologist | 1145 Larpenteur Ave W, Roseville, MN 55113-6335 | 2007-02-26 |
| 1710061932 | Walmart Stores, Inc. | Technician/Technologist | 1400 Lead Hill Blvd, Roseville, CA 95661-2949 | 2006-10-24 |
| 1508973025 | Us Vision Optical Inc | Technician/Technologist | Hwy 36 & Fairview Ave, Roseville, MN 55113 | 2006-08-23 |
| 1215337241 | Wal-mart Stores, Inc | Technician/Technologist | 1400 Lead Hill Blvd, Roseville, CA 95661-2949 | 2014-08-27 |
| Find all providers in ROSEVILLE | ||||
Please comment or provide details below to improve the information on SAM'S CLUB OPTICAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.