SAM'S CLUB OPTICAL (NPI# 1184886913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184886913 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30 4718 |
| Practice Address |
11278 South Jordan Gtwy South Jordan UT 84095 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0235 |
| Practice Telephone | 8015459801 |
| Mailing Telephone | 4792779373 |
| Mailing Fax Number | 4792778176 |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2008-07-02 |
| Authorized Official Name | DAVID J SIMMONS (NPI ASSOCIATE) |
| Authorized Official Telephone | 4792779373 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers | ||
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| Sam's Club Optical 30 4718 | 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 |
| 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 |
| 1881876118 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 440 Payne Rd, Scarborough, ME 04074-8928 | 2007-11-28 |
| Street Address |
11278 SOUTH JORDAN GTWY |
| City | SOUTH JORDAN |
| State | UT |
| Zip Code | 84095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033745393 | Beverly Laraine Williams | Social Worker | 11260 S River Heights Drive, South Jordan, UT 84095 | 2020-03-19 |
| 1265902902 | Sarah Richele Kelley | Specialist/Technologist | 10236 Alder Grovey Way, South Jordan, UT 84095 | 2018-11-26 |
| 1326528837 | Kristi Couse | Massage Therapist | 10679 S 2200 W Apt 2, South Jordan, UT 84095 | 2018-08-15 |
| 1821516063 | River Crossing Dental Professional Corporation | Clinic/Center | 12427 South 4000 West, Suite #200, Riverton, UT 84095 | 2017-09-08 |
| 1245755719 | Staci Stout | Dental Hygienist | 3113 W Swiss Pass Cir, South Jordan, UT 84095 | 2017-08-07 |
| 1437698750 | Ryan Sears | Dentist | 10894 So. River Front Parkway, South Jordan, UT 84095 | 2017-02-20 |
| 1366989931 | Ultimate Sports Regenerative Medicine | Chiropractor | 1098 W. South Jordan Pkwy, Suite 101, South Jordan, UT 84095 | 2017-01-20 |
| 1306393889 | Tal Quirl | Optometrist | 3571 W. 10400 S., South Jordan, UT 84095 | 2016-09-01 |
| 1023562667 | Sevon Taroian | Social Worker | 11260 River Heights Drive, South Jordan, UT 84095 | 2016-08-11 |
| 1952762932 | Megan Buckley | Developmental Therapist | 881 Baxter Drive, Ste 100, South Jordan, UT 84095 | 2016-03-17 |
| Find all providers in zip 84095 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801115316 | America's Best Contasts & Eyeglasses | Technician/Technologist | 11534 District Dr Ste 100, South Jordan, UT 84095-5775 | 2010-05-24 |
| 1932570348 | Wal-mart Stores, Inc | Technician/Technologist | 3590 W South Jordan Pkwy, South Jordan, UT 84095-8916 | 2015-10-12 |
| 1841380821 | Wal-mart Stores, Inc | Technician/Technologist | 11328 S Jordan Gtwy, South Jordan, UT 84095-4112 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821643982 | Aubri Ann Stclair | Technician/Technologist | 1036 E Waddell St, Eagle Mountain, UT 84005-4239 | 2019-08-06 |
| 1043705817 | National Vision, Inc. | Technician/Technologist | 70 S 500 W, Bountiful, UT 84010-8727 | 2018-06-25 |
| 1376038141 | National Vision, Inc. | Technician/Technologist | 821 West Riverdale Road, Riverdale, UT 84405 | 2018-06-25 |
| 1841648664 | National Vision, Inc. | Technician/Technologist | 545 E University Pkwy, Ste 103, Orem, UT 84097 | 2016-06-02 |
| 1366807190 | National Vision, Inc. | Technician/Technologist | 519 East 12300 South, Draper, UT 84020 | 2015-12-21 |
| 1033514336 | National Vision, Inc. | Technician/Technologist | 771 W Grassland Dr, American Fork, UT 84003-5615 | 2014-10-29 |
| 1154726842 | National Vision, Inc. | Technician/Technologist | 2569 South 5600 West, Ste A 550, West Valley, UT 84120 | 2014-10-24 |
| 1437580768 | Salt City Optics LLC | Technician/Technologist | 150 W Commonwealth Ave, Salt Lake City, UT 84115-2539 | 2013-12-12 |
| 1649592965 | America's Best Contacts & Eyeglasses | Technician/Technologist | 844 W Telegraph St Ste 3, Washington, UT 84780-1786 | 2010-03-01 |
| 1285866871 | Joy Gibb | Technician/Technologist | 1608 S 1220 W, Woods Cross, UT 84087-2373 | 2009-08-14 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH JORDAN |
| Zip Code | 84095 |
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.