SAMS CLUB OPTICAL (NPI# 1124129887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124129887 |
| Entity Type | Organization |
| Organization Name | SAMS CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-8184 |
| Practice Address |
6570 Grand Ave Gurnee IL 60031-1621 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-6209 |
| Practice Telephone | 8478551130 |
| Enumeration Date | 2006-09-26 |
| 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 30-8184 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932290475 | Sams Club Optical | Technician/Technologist | 2550 Immokalee Rd, Naples, FL 34110-1410 | 2006-09-28 |
| Street Address |
6570 GRAND AVE |
| City | GURNEE |
| State | IL |
| Zip Code | 60031-1621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306863691 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 6570 Grand Ave, Gurnee, IL 60031-1621 | 2006-07-16 |
| 1568062800 | Anna Majerczak | Pharmacist | 6570 Grand Ave, Gurnee, IL 60031-1621 | 2020-10-27 |
| 1477600518 | Daniel Nast Jr. | Optometrist | 6570 Grand Ave, Co Sams Club, Gurnee, IL 60031 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881174720 | Rockelle Waggoner | Behavioral Analyst | 489 Tanglewood Dr, Gurnee, IL 60031 | 2018-08-20 |
| 1316434376 | Lake County Internal Medicine Assoc LLC | Non-Pharmacy Dispensing Site | 15 Tower Ct., Ste 190, Gurnee, IL 60031 | 2018-04-16 |
| 1588163364 | Advanced Endodontics, PC | Dentist | 103 S. Greenleaf Street, Suite K, Gurnee, IL 60031 | 2018-02-07 |
| 1578081550 | Northshore Medical Consultants, Ltd | Family Medicine | 1425 Hunt Club Rd. #302, Gurnee, IL 60031 | 2017-08-30 |
| 1336678739 | Sarah Beth Fugelseth | Nurse Practitioner | 1445 N Hunt Club Rd Ste 304, Gurnee, IL 60031 | 2017-06-08 |
| 1174079867 | Lifecarepros, LLC | In Home Supportive Care | 223 North Route 21, Gurnee, IL 60031 | 2016-09-01 |
| 1740733195 | Ryan Lee Winslow | Chiropractor | 6021 Washington St, Unit B, Gurnee, IL 60031 | 2016-08-02 |
| 1891129599 | Smart Scan Mri, LLC | Clinic/Center | 350 S. Greenleaf, Suite 401, Gurnee, IL 60031 | 2013-08-29 |
| 1568720076 | Yudelca Romano | Genetic Counselor, MS | 1125 Tri State Parkway, Gurnee, IL 60031 | 2012-05-03 |
| 1558637348 | Laura E Novak | Social Worker | 4212 Old Grand Avenue, Gurnne, IL 60031 | 2012-03-27 |
| Find all providers in zip 60031 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720571615 | National Vision, Inc. | Technician/Technologist | 6931 Grand Ave Ste E2, Gurnee, IL 60031-1610 | 2018-06-14 |
| 1831219369 | Pearle Vision | Technician/Technologist | 6641 Grand Ave Ste D, Gurnee, IL 60031-5262 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902445570 | Kami Optical Corp | Technician/Technologist | 1163 E Ogden Ave Ste 701, Naperville, IL 60563-8535 | 2019-12-31 |
| 1750847281 | National Vision Inc | Technician/Technologist | 750 S Rand Rd, Lake Zurich, IL 60047-2467 | 2019-02-20 |
| 1700364171 | National Vision Inc | Technician/Technologist | 4068 North Milwaukee Avenue, Chicago, IL 60641 | 2018-07-30 |
| 1023528619 | Direct Healthcare Solutions LLC | Technician/Technologist | 1520 Fringetree Ln, Woodridge, IL 60517-4653 | 2017-10-09 |
| 1184140014 | Efp Opticians On Dearborn, LLC | Technician/Technologist | 1205 N Dearborn St, Chicago, IL 60610-2213 | 2017-08-22 |
| 1235668245 | Vision Man | Technician/Technologist | 8335 Grand Ave, River Grove, IL 60171-1434 | 2017-06-05 |
| 1033662200 | National Vision, Inc. | Technician/Technologist | 348 W Army Trail Rd, Suite 130, Bloomingdale, IL 60108-5608 | 2016-07-25 |
| 1780039115 | Wal-mart Stores, Inc. | Technician/Technologist | 365 Lake Marian Road, Carpentersville, IL 60110 | 2016-05-04 |
| 1346695392 | National Vision, Inc. | Technician/Technologist | 714 S Randall Rd, Algonquin, IL 60102-5915 | 2016-04-27 |
| 1306290788 | National Vision | Technician/Technologist | 700 N Milwaukee Ave, Unit 131, Vernon Hills, IL 60061-1593 | 2016-04-21 |
| Find all providers with the same taxonomy | ||||
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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.