SAM'S CLUB OPTICAL (NPI# 1295835312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295835312 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6358 |
| Practice Address |
141 W North Ave Northlake IL 60164-2322 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 7085310807 |
| Enumeration Date | 2006-09-25 |
| 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 30-6358 | 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 |
141 W NORTH AVE |
| City | NORTHLAKE |
| State | IL |
| Zip Code | 60164-2322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770500068 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 141 W North Ave, Northlake, IL 60164-2322 | 2006-07-16 |
| 1336749639 | Daniel Michael Lynch I | Pharmacist | 141 W North Ave, Northlake, IL 60164-2389 | 2020-10-27 |
| 1710153069 | Frederick John Fagan | Optometrist | 141 W North Ave, Northlake, IL 60164-2322 | 2008-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629625892 | Bazartogtokh Bayar | Technician | 2248 Calwagner Ave, Melrose Park, IL 60164 | 2019-08-22 |
| 1669809752 | Murry W Randell | Dentist | 338 E North Av, Northlake, IL 60164 | 2013-10-03 |
| 1023002318 | Presence Senior Services Chicagoland | Skilled Nursing Facility | 480 N Wolf Rd, North Lake, IL 60164 | 2005-09-01 |
| 1912165325 | Northlake Dental Clinic PC | Dentist | 161 E North Ave, Northlake, IL 60164 | 2008-06-02 |
| 1679658132 | Kindred Thc Chicago, LLC | Long Term Care Hospital | 365 E North Ave, Northlake, IL 60164 | 2006-10-25 |
| 1932584059 | Vishali Banathia | Pharmacist | 2912 Marion Ave, Melrose Park, IL 60164-1002 | 2015-07-30 |
| 1821546938 | Anoop Banathia | Registered Nurse | 2912 Marion Ave, Melrose Park, IL 60164-1002 | 2016-09-18 |
| 1356596670 | Monica Saavedra-kulousek | Psychologist | 916 N Prater Ave, Melrose Park, IL 60164-1111 | 2008-12-01 |
| 1851644249 | Anjelica Sierra | Speech-Language Pathologist | 2944 Haber Ave, Melrose Park, IL 60164-1132 | 2012-10-22 |
| 1174910632 | Ellen Locke | Social Worker | 1000 N Wolf Rd, Northlake, IL 60164-1438 | 2015-04-22 |
| Find all providers in zip 60164 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639182884 | Wal-mart Stores, Inc. | Technician/Technologist | 137 W North Ave, Northlake, IL 60164-2316 | 2006-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902445570 | Kami Optical Corp | Technician/Technologist | 1163 E Ogden Ave Ste 701, Naperville, IL 60563-8535 | 2019-12-31 |
| 1750847281 | National Vision Inc | Technician/Technologist | 750 S Rand Rd, Lake Zurich, IL 60047-2467 | 2019-02-20 |
| 1700364171 | National Vision Inc | Technician/Technologist | 4068 North Milwaukee Avenue, Chicago, IL 60641 | 2018-07-30 |
| 1720571615 | National Vision, Inc. | Technician/Technologist | 6931 Grand Ave Ste E2, Gurnee, IL 60031-1610 | 2018-06-14 |
| 1023528619 | Direct Healthcare Solutions LLC | Technician/Technologist | 1520 Fringetree Ln, Woodridge, IL 60517-4653 | 2017-10-09 |
| 1184140014 | Efp Opticians On Dearborn, LLC | Technician/Technologist | 1205 N Dearborn St, Chicago, IL 60610-2213 | 2017-08-22 |
| 1235668245 | Vision Man | Technician/Technologist | 8335 Grand Ave, River Grove, IL 60171-1434 | 2017-06-05 |
| 1033662200 | National Vision, Inc. | Technician/Technologist | 348 W Army Trail Rd, Suite 130, Bloomingdale, IL 60108-5608 | 2016-07-25 |
| 1780039115 | Wal-mart Stores, Inc. | Technician/Technologist | 365 Lake Marian Road, Carpentersville, IL 60110 | 2016-05-04 |
| 1346695392 | National Vision, Inc. | Technician/Technologist | 714 S Randall Rd, Algonquin, IL 60102-5915 | 2016-04-27 |
| 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.