SAM'S CLUB OPTICAL (NPI# 1205911146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205911146 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-4786 |
| Practice Address |
145 W Cache Valley Blvd Logan UT 84341-8473 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-6209 |
| Practice Telephone | 4357870063 |
| Enumeration Date | 2006-10-26 |
| 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 30-4786 | 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 |
145 W CACHE VALLEY BLVD |
| City | LOGAN |
| State | UT |
| Zip Code | 84341-8473 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255358453 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 145 W Cache Valley Blvd, Logan, UT 84341-8473 | 2006-07-16 |
| 1114401130 | Jesse T Li | Pharmacist | 145 W Cache Valley Blvd, Logan, UT 84341-8473 | 2018-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701529 | Aubrey Salmond | Registered Nurse | 500 East 1500 N, Logan, UT 84341 | 2019-10-11 |
| 1043702046 | Eye Pros of Logan LLC | Optometrist | 1475 N Main St Ste 103, Logan, UT 84341 | 2018-06-05 |
| 1275050452 | Rylie Jeanne Cook | Student in an Organized Health Care Education/Training Program | 11 Aggie Village Apt. J, Logan, UT 84341 | 2017-08-28 |
| 1093262156 | Jessica Lynn Mcgarry | Social Worker | 1040 N 130 W, Apt 100, Logan, UT 84341 | 2016-09-07 |
| 1740663566 | Paul R Gregory | Occupational Therapy Assistant | 1300 N 500 E Suite 120, Suite 120, Logan, UT 84341 | 2015-06-30 |
| 1851708846 | Bradley Budge | Optometrist | 535 E 1400 N Ste 130, Logan, UT 84341 | 2014-07-22 |
| 1386058709 | Daniel Raymond Carlson | Physician Assistant | 500 E. 1400 N., Logan, UT 84341 | 2014-06-13 |
| 1902220239 | Work Injury Solutions Inc. | Clinic/Center | 630 E 1400 N Ste 140, Logan, UT 84341 | 2014-02-06 |
| 1750627287 | Lee Martin Williams Sr. | Counselor | 186 E. 1800 N., North Logan, UT 84341 | 2013-01-03 |
| 1669747804 | Ronald J Payne | Internal Medicine | 1726 North 1850 East, North Logan, UT 84341 | 2012-03-21 |
| Find all providers in zip 84341 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922018886 | Robert E. Baldwin | Technician/Technologist | 1451 N 200 E Ste 195, Logan, UT 84341-7574 | 2006-08-09 |
| 1740659275 | Wal-mart Stores, Inc. | Technician/Technologist | 1150 S 100 W, Logan, UT 84321-5573 | 2015-09-15 |
| 1568596054 | Krystal Vision and Sunwear Inc | Technician/Technologist | 550 E 1400 N, Suite P, Logan, UT 84341-2406 | 2007-03-15 |
| 1619053808 | Wal-mart Stores, Inc. | Technician/Technologist | 1550 N Main St, Logan, UT 84341-1918 | 2006-10-31 |
| 1720182819 | Wal-mart Stores East, Lp | Technician/Technologist | 12910 State Route 664 S, Logan, OH 43138-8564 | 2006-09-11 |
| 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 |
| 1801115316 | America's Best Contasts & Eyeglasses | Technician/Technologist | 11534 District Dr Ste 100, South Jordan, UT 84095-5775 | 2010-05-24 |
| 1649592965 | America's Best Contacts & Eyeglasses | Technician/Technologist | 844 W Telegraph St Ste 3, Washington, UT 84780-1786 | 2010-03-01 |
| 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.