SAM'S CLUB OPTICAL (NPI# 1316039845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316039845 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6665 |
| Practice Address |
495 Summit Dr Waterford MI 48328-3368 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 2487385002 |
| Enumeration Date | 2006-09-29 |
| 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 30-6665 | 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 |
495 SUMMIT DR |
| City | WATERFORD |
| State | MI |
| Zip Code | 48328-3368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912924135 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 495 Summit Dr, Waterford, MI 48328-3368 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477184125 | Lillian Atty | Pharmacist | 1484 Rivona Dr, Waterford, MI 48328 | 2020-01-31 |
| 1437631850 | Rana Ismail | Pharmacist | 3273 West Huron St, Waterford, MI 48328 | 2018-09-01 |
| 1588181978 | India Dunlap | Social Worker | 279 Summit Dr., Waterford, MI 48328 | 2017-08-25 |
| 1689191280 | Sydney Strandberg | Social Worker | 1145 Parkway, Waterford, MI 48328 | 2017-08-24 |
| 1467982074 | Briana Greenlee | Dietitian, Registered | 3819 Faber Terrace, Waterford, MI 48328 | 2017-06-15 |
| 1922537364 | Lourdes Alzheimer's Special Care | Custodial Care Facility | 2400 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1013446459 | Lourdes Assisted Living | Assisted Living Facility | 2450 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1588019053 | Legacy Dermatology Group PC | Dermatology | 1392 S Cass Lake Rd, Waterford, MI 48328 | 2016-05-03 |
| 1932567989 | Devenia Denise Clayter | Counselor | 255 Summit Dr, Waterford, MI 48328 | 2016-02-05 |
| 1922409739 | Stacey Diggs | Counselor | 250 Elizabeth Lake Road, Biomed Behavorial Healthcare, Waterford, MI 48328 | 2014-09-11 |
| Find all providers in zip 48328 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538397419 | Elizabeth Fague | Technician/Technologist | 155 Waterford Parkway N., Waterford, CT 06385 | 2009-06-30 |
| 1023245776 | Bradley Peter Bohman | Technician/Technologist | Vision Center, 155 Waterford Pkwy North, Waterford, CT 06385 | 2009-06-19 |
| 1629235031 | Fluegge Optical | Technician/Technologist | 920 E Main Street, Waterford, WI 53185 | 2008-05-22 |
| 1609048172 | Koc Inc | Technician/Technologist | 5660 Dixie Hwy, Waterford, MI 48329-1695 | 2008-03-25 |
| 1841322633 | Cohens Fashion Optical | Technician/Technologist | 850 Hartford Tnpk, Waterford, CT 06385 | 2007-03-09 |
| 1497817712 | Professional Optician Management Services Inc | Technician/Technologist | 741 Broad Street Extension, Waterford, CT 06385 | 2006-12-14 |
| 1063571214 | Professional Opticians Inc | Technician/Technologist | 125 Boston Post Road, Waterford, CT 06385 | 2006-12-06 |
| 1437530995 | Usv Optical Inc. | Technician/Technologist | 125 Cross Rd, Waterford, CT 06385-1203 | 2015-06-10 |
| 1124413703 | Kirk Larsen | Technician/Technologist | 850 Hartford Tpke, Cohens Fashion Optical, Waterford, CT 06385-4238 | 2015-04-01 |
| 1275853541 | William D. Foreman | Technician/Technologist | 131 Boston Post Rd, Suite 4, Waterford, CT 06385-2839 | 2010-06-09 |
| Find all providers in WATERFORD | ||||
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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.