SAM'S CLUB OPTICAL (NPI# 1235221284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235221284 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6378 |
| Practice Address |
6363 Valley Springs Pkwy Riverside CA 92507-0905 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 9516534840 |
| Enumeration Date | 2006-09-28 |
| 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 30-6378 | 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 |
6363 VALLEY SPRINGS PKWY |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92507-0905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730106089 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 6363 Valley Springs Pkwy, Riverside, CA 92507-0905 | 2006-07-16 |
| 1699183368 | Landon Leslie Dean | Pharmacist | 6363 Valley Springs Pkwy, Riverside, CA 92507-0905 | 2014-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448917 | Rachel Nielson | Counselor | 1450 Spruce St, Suite A, Riverside, CA 92507 | 2020-08-24 |
| 1437769742 | Pakravan, Manavi & Cohen Dental Corporation | Dentist | 2862 Unit B Canyon Springs Parkway, Riverside, CA 92507 | 2020-08-03 |
| 1518577972 | Michael Vincent Laureola Dds Inc | Dentist | 2862 Unit A Canyon Springs Parkway, Riverside, CA 92507 | 2020-07-31 |
| 1164067567 | Audrey Gruen | Social Worker | Canyon Crest Mental Health, 5225 Canyon Crest Drive #100, Riverside, CA 92507 | 2019-11-10 |
| 1518432962 | Antonio Mixon | Specialist | 1405 Spruce Street, Suite A, Riverside, CA 92507 | 2018-10-11 |
| 1811479793 | New Day Counseling Services | Counselor | 20363 Harvard Way, Riverside, CA 92507 | 2018-09-06 |
| 1780176875 | Miriam Martinez | Case Manager/Care Coordinator | 2085 Rustin Ave., Riverside, CA 92507 | 2018-06-04 |
| 1518478874 | Lisa Manuel | Counselor | 2058 Rustin Ave, Riverside, CA 92507 | 2017-10-13 |
| 1497272942 | Yajaira Placensia | Behavioral Analyst | 1486 Everton Place, Riverside, CA 92507 | 2017-08-25 |
| 1841717691 | Stephanie Teuchert | Behavioral Analyst | 1080 Spruce Street Apartment 7c, Riverside, CA 92507 | 2017-08-23 |
| Find all providers in zip 92507 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023157146 | A Child's View, Inc. | Technician/Technologist | 10335 Magnolia Ave, Riverside, CA 92505-1809 | 2007-02-05 |
| 1518048651 | Walmart Stores, Inc. | Technician/Technologist | 2663 Canyon Springs Pkwy, Riverside, CA 92507-0911 | 2006-10-17 |
| 1043757123 | National Vision, Inc. | Technician/Technologist | 4030 Madison St, Riverside, CA 92504-2642 | 2017-01-26 |
| 1952545824 | Optical Center | Technician/Technologist | 23640 N St Bldg 758, Riverside, CA 92518-1893 | 2009-04-23 |
| 1336220474 | Walmart Stores, Inc. | Technician/Technologist | 5200 Van Buren Blvd, Riverside, CA 92503-2544 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374744 | John Dibos | Technician/Technologist | 343 W Felicita Ave Ste 10, Escondido, CA 92025-6515 | 2020-10-20 |
| 1720686140 | Lens 4 Less Optical, Inc. | Technician/Technologist | 343 W Felicita Ave # 10, Escondido, CA 92025-6515 | 2020-10-16 |
| 1023620648 | Blanca Estela Maldonado | Technician/Technologist | 671 E Cooley Dr Ste 102, Colton, CA 92324-4014 | 2020-08-17 |
| 1619598406 | Heather Siu Shum | Technician/Technologist | 200 E Garvey Ave Ste 109, Monterey Park, CA 91755-1859 | 2020-05-03 |
| 1932738481 | Enrique Metta Fallena | Technician/Technologist | 651 Palomar St Ste A17, Chula Vista, CA 91911-2663 | 2020-04-06 |
| 1629603659 | Linh Lai | Technician/Technologist | 1111 Story Rd Ste 1079, San Jose, CA 95122-2670 | 2020-03-10 |
| 1548895998 | Randy Liu | Technician/Technologist | 1049 Capen Ave, Walnut, CA 91789-3912 | 2020-03-05 |
| 1780214403 | Gary Alan Bates | Technician/Technologist | 2540 Zanella Way Ste 10, Chico, CA 95928-7194 | 2020-01-22 |
| 1336787696 | Michael Yoshio Sujishi | Technician/Technologist | 150 West Carson Street, Store 8839, Carson, CA 90745 | 2019-12-18 |
| 1609413665 | Yan Zlatin | Technician/Technologist | 21001 Sherman Way # 14a, Canoga Park, CA 91303-1760 | 2019-12-09 |
| 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.