SAM'S CLUB OPTICAL (NPI# 1033214275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033214275 |
Entity Type | Organization |
Organization Name | SAM'S CLUB OPTICAL |
Other Organization Name | SAM'S CLUB OPTICAL 30-8149 |
Practice Address |
2470 W Mason St Green Bay WI 54303-4711 |
Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
Practice Telephone | 9204972112 |
Enumeration Date | 2006-09-13 |
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 30-8149 | 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 |
2470 W MASON ST |
City | GREEN BAY |
State | WI |
Zip Code | 54303-4711 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528085693 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 2470 W Mason St, Green Bay, WI 54303-4711 | 2006-07-16 |
1740814987 | David Haynes Betts IIi | Pharmacy | 2470 W Mason St, Green Bay, WI 54303-4711 | 2020-02-26 |
1093128365 | Paula Hart | Dental Hygienist | 2470 W Mason St, Green Bay, WI 54303-4711 | 2014-06-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
Find all providers in zip 54303 |
Taxonomy Code | 156FX1800X |
Grouping | Eye and Vision Services Providers |
Classification | Technician/Technologist |
Specialization | Optician |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518528033 | Cheryl M Robertson | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2019-06-25 |
1962063495 | Christina L Reek | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2019-06-25 |
1073994133 | Kim Tavener | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2015-06-15 |
1700202538 | America's Best Contacts & Eyeglasses | Technician/Technologist | 1499 W Mason St, Green Bay, WI 54303-2233 | 2014-03-18 |
1346525573 | Vision Mart, Inc | Technician/Technologist | 2476 S Oneida St, Suite 105, Green Bay, WI 54304-5289 | 2011-10-19 |
1770756397 | Judy Winney | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2008-04-03 |
1962675587 | Karen Vandenhouten | Technician/Technologist | 923 Eliza St, Green Bay, WI 54301-3234 | 2008-04-03 |
1558409656 | Wisconsin Vision, Inc. | Technician/Technologist | 2158 W Mason St, Green Bay, WI 54303-4705 | 2007-02-01 |
1386727501 | Wal-mart Stores East, Lp | Technician/Technologist | 2440 W Mason St, Green Bay, WI 54303-4711 | 2006-10-23 |
1184707309 | Wal-mart Stores East, Lp | Technician/Technologist | 2292 Main St, Green Bay, WI 54311-5307 | 2006-10-23 |
Find all providers in GREEN BAY |
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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.