SAM'S CLUB OPTICAL (NPI# 1154411080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154411080 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6310 |
| Practice Address |
8150 University Ave Ne Fridley MN 55432-1864 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 7637844102 |
| Enumeration Date | 2006-10-13 |
| 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 30-6310 | 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 |
8150 UNIVERSITY AVE NE |
| City | FRIDLEY |
| State | MN |
| Zip Code | 55432-1864 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275550675 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 8150 University Ave Ne, Fridley, MN 55432-1864 | 2006-07-16 |
| 1588190961 | Lg Vision Services LLC | Optometrist | 8150 University Ave Ne, Fridley, MN 55432-1864 | 2017-05-04 |
| 1689710956 | Linda Jean Logan | Audiologist | 8150 University Ave Ne, Sam's Club Hearing Aid Center, Fridley, MN 55432-1864 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791177 | Adelyn Ruth Kopp | Occupational Therapist | 500 Osborne Rd Ne Suite 365, Fridley, MN 55432 | 2019-07-11 |
| 1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
| 1518402213 | Peaceful Adult Day Center LLC. | Home Health | 6267 University Ave Ne, Fridley, MN 55432 | 2017-01-04 |
| 1205383742 | Farhiya Mahamud Gelle I | Durable Medical Equipment & Medical Supplies | 6329 5th Street Ne Apt 8, Fridley, MN 55432 | 2016-09-01 |
| 1093163164 | Christiane Schwecke | Specialist/Technologist | 8290 University Ave N, Fridley, MN 55432 | 2016-05-31 |
| 1336551563 | Amy White Mountain | Massage Therapist | 1611 County Hwy 10 Ne, Spring Lake Park, MN 55432 | 2014-05-22 |
| 1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
| 1952648180 | John Franklyn Marshall | Family Medicine | 480 Osborne Road Ne, Suite 100, Fridley, MN 55432 | 2013-01-08 |
| 1558610519 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 480 Osborne Road, Number 280, Fridley, MN 55432 | 2012-09-06 |
| 1336423391 | Christian Restoration Services | Counselor | 7157 Commerce Circle W, Fridley, MN 55432 | 2011-10-07 |
| Find all providers in zip 55432 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932305489 | Dr Petronack & Associates Optometrists Inc | Technician/Technologist | 7510 University Ave Ne, Fridley, MN 55432-2614 | 2007-06-22 |
| 1598843617 | Bradley A Krider | Technician/Technologist | 624 Osborne Rd Ne, Fridley, MN 55432-2719 | 2006-11-02 |
| 1275767378 | Judy Joann Johnson | Technician/Technologist | 7362 University Ave Ne, 206, Fridley, MN 55432-3142 | 2009-05-05 |
| 1114000809 | Wal-mart Stores, Inc. | Technician/Technologist | 8450 University Ave Ne, Fridley, MN 55432-1164 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821558370 | National Vision Inc | Technician/Technologist | 8348 Highway 7, Saint Louis Park, MN 55426-3907 | 2019-03-21 |
| 1861937112 | Personality Eyewear | Technician/Technologist | 8257 Logan Ave N, Brooklyn Park, MN 55444-1545 | 2016-12-22 |
| 1871961185 | Wal-mart Stores, Inc | Technician/Technologist | 3001 E Highway 7, Montevideo, MN 56265-4556 | 2015-09-03 |
| 1215316682 | National Vision, Inc. | Technician/Technologist | 12940 Riverdale Dr Nw, Ste 300, Coon Rapids, MN 55448-8412 | 2015-05-19 |
| 1619354156 | National Vision, Inc. | Technician/Technologist | 1727 Beam Ave, Ste D, Maplewood, MN 55109-1164 | 2015-05-05 |
| 1124437223 | America's Best Contacts & Eyeglasses | Technician/Technologist | 6096 Shingle Creek Pkwy, Brooklyn Center, MN 55430-2316 | 2014-08-04 |
| 1942622089 | Wal-mart Stores, Inc. | Technician/Technologist | 9300 East Point Douglas Rd S, Cottage Grove, MN 55016 | 2014-01-08 |
| 1851712384 | Marshall Allan Daly | Technician/Technologist | 2484 University Ave W, Saint Paul, MN 55114-1735 | 2013-12-31 |
| 1174966683 | David Yang | Technician/Technologist | 987 Oday St S, Maplewood, MN 55119-5953 | 2013-04-15 |
| 1063760817 | Wal-mart Stores Inc | Technician/Technologist | 1200 Shingle Creek Crossing, Brooklyn Center, MN 55430 | 2012-08-28 |
| 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.