SAM'S CLUB OPTICAL (NPI# 1356427546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356427546 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6633 |
| Practice Address |
4700 Boardwalk Dr Fort Collins CO 80525-3729 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 9702290797 |
| Enumeration Date | 2006-10-31 |
| 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 30-6633 | 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 |
4700 BOARDWALK DR |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80525-3729 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154348431 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 4700 Boardwalk Dr, Fort Collins, CO 80525-3729 | 2006-07-16 |
| 1558924084 | Jacqueline Renee Trautwein | Pharmacist | 4700 Boardwalk Dr, Fort Collins, CO 80525-3729 | 2019-04-19 |
| 1316500481 | Eric Rewerts | Pharmacist | 4700 Boardwalk Dr, Fort Collins, CO 80525-3729 | 2019-04-15 |
| 1336348846 | Clinton D Kliewer | Optometrist | 4700 Boardwalk Dr, Fort Collins, CO 80525-3729 | 2007-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356950299 | Kelly Westbrook Schmalstich | Clinical Nurse Specialist | 2020 Blue Yonder Way, Fort Collins, CO 80525 | 2020-07-27 |
| 1912522376 | Tender Gifts Midwifery and Birth Center | Clinical Nurse Specialist | 1817 Jessup Dr Farms, Fort Collins, CO 80525 | 2020-06-11 |
| 1114566015 | Andrea Nicole Brogdon | Acupuncturist | 2501 S. College Ave, Fort Collins, CO 80525 | 2019-12-26 |
| 1013553593 | Kids Overcoming, LLC | Home Health | 1330 Oakridge Drive Suite 105, Fort Collins, CO 80525 | 2019-11-20 |
| 1568019966 | Julia Heithoff | Behavioral Analyst | 1100 Haxton Dr #115, Fort Collins, CO 80525 | 2019-08-20 |
| 1144875246 | Harmony Smiles Dentistry, LLP | Dentist | 356 E Harmony Rd., #6-a, Fort Collins, CO 80525 | 2019-08-06 |
| 1841774502 | Shannon L Harris | Social Worker | 305 Carpenter Road, Fort Collins, CO 80525 | 2018-09-19 |
| 1306332101 | Joshua Evans Brooks | Optometrist | 375 E Horsetooth Rd Bldg 5 Ste 201, Fort Collins, CO 80525 | 2018-07-03 |
| 1285120212 | Danae Fuqua | Physical Medicine & Rehabilitation | Covell Care & Rehabilitation, 2350 Limon Dr., Fort Collins, CO 80525 | 2018-07-02 |
| 1528552890 | Megan E Locke | Audiologist | 724 Whalers Way Bdg I, Suite 101, Fort Collins, CO 80525 | 2018-06-19 |
| Find all providers in zip 80525 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366914145 | Dennis Bell | Technician/Technologist | 102 W Mountain Ave, Fort Collins, CO 80524-2823 | 2018-12-18 |
| 1891197455 | Edward Benks | Technician/Technologist | 2929 Ross Dr, S73, Fort Collins, CO 80526-6639 | 2014-09-25 |
| 1437498763 | Dylan O'brien | Technician/Technologist | 145 W Swallow Rd, Fort Collins, CO 80525-2500 | 2013-02-06 |
| 1043513443 | William James Wood | Technician/Technologist | 918 Mansfield Dr, Fort Collins, CO 80525-2821 | 2010-12-07 |
| 1104146927 | 2lazy2, LLC | Technician/Technologist | 2613 Red Mountain Court, Fort Collins, CO 80525 | 2010-06-03 |
| 1760622203 | America's Best Contacts & Eyeglasses | Technician/Technologist | 2720 Council Tree Ave Ste 148, Fort Collins, CO 80525-6309 | 2009-02-24 |
| 1255758181 | The Glasses Guys LLC | Technician/Technologist | 145 W Swallow Rd, Fort Collins, CO 80525-2500 | 2014-03-28 |
| 1376628941 | Wal-mart Stores, Inc. | Technician/Technologist | 1250 E Magnolia St, Fort Collins, CO 80524-2754 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730652660 | National Vision Inc | Technician/Technologist | 2406 S Parker Rd Ste C, Denver, CO 80231-4381 | 2019-01-03 |
| 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 |
| 1952772402 | National Vision, Inc. | Technician/Technologist | 2780 S Colorado Blvd, Ste 300, Denver, CO 80222-6629 | 2015-10-09 |
| Find all providers with the same taxonomy | ||||
| City | FORT COLLINS |
| Zip Code | 80525 |
Please comment or provide details below to improve the information on SAM'S CLUB OPTICAL.
| 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.