SAM'S CLUB OPTICAL (NPI# 1124128921) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124128921 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL |
| Practice Address |
13360 Cortez Blvd Brooksville FL 34613-4887 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 3525924737 |
| Enumeration Date | 2006-09-22 |
| 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 | 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 |
13360 CORTEZ BLVD |
| City | BROOKSVILLE |
| State | FL |
| Zip Code | 34613-4887 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235156530 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 13360 Cortez Blvd, Brooksville, FL 34613-4887 | 2006-07-16 |
| 1861093734 | Dorothy Denise Mccoy | Pharmacist | 13360 Cortez Blvd, Brooksville, FL 34613-4887 | 2020-11-05 |
| 1972104248 | Janet Moffett | Pharmacist | 13360 Cortez Blvd, Brooksville, FL 34613-4887 | 2020-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679196836 | Izza Bazigh | Student in an Organized Health Care Education/Training Program | 11375 Cortez Boulevard, Sr 50, Office of Graduate Medic, Brooksville, FL 34613 | 2020-05-22 |
| 1003446824 | Spring Hill Pediatric Dentistry, LLC | Dentist | 7140 Sagheer St., Brooksville, FL 34613 | 2020-01-21 |
| 1407405822 | Medical Risk Solutions | Family Medicine | 12080 Cortez Blvd, Brooksville, FL 34613 | 2019-09-09 |
| 1528529245 | Edward Joseph Waseleski Jr. | Student in an Organized Health Care Education/Training Program | 11375 Cortez Blvd., State Road 50, Brooksville, FL 34613 | 2019-03-26 |
| 1366903213 | Paresh Rangani | Student in an Organized Health Care Education/Training Program | 11375 Cortez Blvd., State Road 50, Brooksville, FL 34613 | 2019-03-25 |
| 1225558034 | Whitney King | Student in an Organized Health Care Education/Training Program | 11375 Cortez Boulevard, State Road 50, Brooksville, FL 34613 | 2017-06-22 |
| 1922450022 | Visionworks, Inc | Eyewear Supplier (Equipment, not the service) | 13217 Cortez Rd, Brooksville, FL 34613 | 2016-07-13 |
| 1992157408 | Arushi Goel | Internal Medicine | 11375 Cortez Boulevard, Oak Hill Hospital, Brooksville, FL 34613 | 2016-07-08 |
| 1366823122 | Monicka Stella Felix | Internal Medicine | 11375 Cortez Boulevard, Sr 50, Oak Hill Hospital, Gme Attn: Melissa Tammaro, Brooksville, FL 34613 | 2015-06-17 |
| 1790171700 | April Greer | Hearing Instrument Specialist | 13013 Cortez Blvd., Brooksville, FL 34613 | 2015-04-07 |
| Find all providers in zip 34613 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760690135 | Gary Leonard Jacobs | Technician/Technologist | 13132 Cortez Blvd, Brooksville, FL 34613-4858 | 2007-05-18 |
| 1447262431 | Terry Allen Key | Technician/Technologist | 1202 S Broad St, Brooksville, FL 34601-3132 | 2006-08-11 |
| 1902405988 | Casey Mogus | Technician/Technologist | 13161 Cortez Blvd, Brooksville, FL 34613-7804 | 2020-10-21 |
| 1801419676 | Michelle M Toledo | Technician/Technologist | 7631 Horse Lake Rd, Brooksville, FL 34601-9021 | 2020-05-27 |
| 1376020008 | Laurie Ann Marcionette | Technician/Technologist | 13128 Cortez Blvd, Brooksville, FL 34613-4858 | 2018-07-25 |
| 1376955112 | Marianela Lee | Technician/Technologist | 13132 Cortez Blvd, Brooksville, FL 34613-4858 | 2014-05-28 |
| 1679985410 | Carolyn Marie Burger | Technician/Technologist | 13132 Cortez Blvd, Brooksville, FL 34613-4858 | 2014-05-28 |
| 1740497676 | Optimart, Inc. | Technician/Technologist | 13161 Cortez Blvd, Brooksville, FL 34613-7804 | 2007-05-17 |
| 1760567697 | Wal-mart Stores East, Lp | Technician/Technologist | 13300 Cortez Blvd, Brooksville, FL 34613-4887 | 2006-10-26 |
| 1588755615 | Wal-mart Stores East, Lp | Technician/Technologist | 7305 Broad St, Brooksville, FL 34601-3158 | 2006-09-27 |
| Find all providers in BROOKSVILLE | ||||
| City | BROOKSVILLE |
| Zip Code | 34613 |
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.