SAM'S CLUB OPTICAL (NPI# 1285723981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285723981 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6549 |
| Practice Address |
412 Eagleridge Blvd Pueblo CO 81008-2100 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 7195843028 |
| Enumeration Date | 2006-10-12 |
| 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 30-6549 | 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 |
412 EAGLERIDGE BLVD |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-2100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245257526 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 412 Eagleridge Blvd, Pueblo, CO 81008-2100 | 2006-07-16 |
| 1497318448 | Eric Lorensen | Pharmacist | 412 Eagleridge Blvd, Pueblo, CO 81008-2100 | 2019-04-16 |
| 1093905614 | Terri Steddum | Optometrist | 412 Eagleridge Blvd, Pueblo, CO 81008-2100 | 2007-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058913 | Healthone Clinic Services - Oncology Hematology LLC | Internal Medicine | 3678 Parker Blvd, Pueblo, CO 81008 | 2020-03-12 |
| 1073026423 | Carmel Community Living Corporation | Respite Care | 2003 Northmoor Terrace, Suite 100, Pueblo, CO 81008 | 2017-11-08 |
| 1568987121 | Hannah Vivian Roadruck | Pharmacist | 4200 Dillon Dr., Pueblo, CO 81008 | 2017-08-04 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1649624362 | Curley Peak Dentistry Pllc | Dentist | 1640 W Fortino Blvd, Pueblo, CO 81008 | 2016-04-19 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1417327461 | Nicole Betts | Registered Nurse | 1310 Fortino Blvd Ste D, Pueblo, CO 81008 | 2015-10-02 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
| Find all providers in zip 81008 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801062757 | America's Best Contacts & Eyeglasses | Technician/Technologist | 1761 S Pueblo Blvd, Pueblo, CO 81005-2103 | 2008-05-01 |
| 1508948241 | Wal-mart Stores, Inc. | Technician/Technologist | 4080 W Northern Ave, Pueblo, CO 81005-3503 | 2006-10-20 |
| 1710077995 | Walmart Stores, Inc. | Technician/Technologist | 4200 Dillon Dr, Pueblo, CO 81008-2113 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730652660 | National Vision Inc | Technician/Technologist | 2406 S Parker Rd Ste C, Denver, CO 80231-4381 | 2019-01-03 |
| 1366914145 | Dennis Bell | Technician/Technologist | 102 W Mountain Ave, Fort Collins, CO 80524-2823 | 2018-12-18 |
| 1568976462 | National Vision, Inc | Technician/Technologist | 9609 A 2 East County Line Rd, Englewood, CO 80112 | 2017-11-30 |
| 1083134431 | Kids Spectacle Shop | Technician/Technologist | 2575 Pearl St Ste 1c, Boulder, CO 80302-3851 | 2017-06-26 |
| 1093257248 | B&s Inc. | Technician/Technologist | 2751 S Parker Rd, Suite 402, Aurora, CO 80014-2700 | 2016-11-04 |
| 1710436449 | International Optique Inc | Technician/Technologist | 7800 E Hampden Ave, Denver, CO 80231-4885 | 2016-09-22 |
| 1831647783 | National Vision, Inc. | Technician/Technologist | 1670 E Cheyenne Mountain Blvd, Ste N1 & M, Colorado Springs, CO 80906-4035 | 2016-09-20 |
| 1366892531 | Vision Coat Inc | Technician/Technologist | 7800 E Iliff Ave, Denver, CO 80231-7009 | 2016-06-17 |
| 1619341070 | Dan Tholen | Technician/Technologist | 1720 Julian St, Denver, CO 80204-1621 | 2015-11-23 |
| 1245601509 | Russell Poley | Technician/Technologist | 7007 E 88th Ave, L-50, Henderson, CO 80640-8214 | 2015-10-13 |
| 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.