SAM'S CLUB OPTICAL (NPI# 1356516116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356516116 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6644 |
| Practice Address |
3839 Mundy Mill Road Oakwood GA 30566 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0235 |
| Practice Telephone | 7702877716 |
| Mailing Telephone | 4792779373 |
| Mailing Fax Number | 4792778176 |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |
| Authorized Official Name | DAVID J SIMMONS (NPI ASSOCIATE) |
| Authorized Official Telephone | 4792779373 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers | ||
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| Sam's Club Optical 30-6644 | 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 |
| 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 |
| 1881876118 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 440 Payne Rd, Scarborough, ME 04074-8928 | 2007-11-28 |
| Street Address |
3839 MUNDY MILL ROAD |
| City | OAKWOOD |
| State | GA |
| Zip Code | 30566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811480676 | Travis Core | Physical Therapist | 4220 Mundy Mill Pl Ste 2b, Oakwood, GA 30566 | 2018-06-07 |
| 1174922751 | Luke Lenahan | Physician Assistant | 3931 Mundy Mill Rd., Ste B, Oakwood, GA 30566 | 2014-08-19 |
| 1144584384 | Stephanie Mccullum | Occupational Therapist | 1006 Creeekside Place, Oakwood, GA 30566 | 2012-07-03 |
| 1528357951 | Extended Care Center of Oakwood LLC | Family Medicine | 4205 Mundy Mill Pl., Suite 1, Oakwood, GA 30566 | 2011-04-06 |
| 1265673305 | Patti P Shipp | Counselor | 4347 Mundy Mill Rd Ste A2, Oakwood, GA 30566 | 2009-03-19 |
| 1124281217 | Ionut Radu | Optometrist | 3839 Mundy Mills Road, Oakwood, GA 30566 | 2008-07-08 |
| 1851423057 | Oakwood Medical Clinic | Clinic/Center | 3626 Old Oakwood Rd, Oakwood, GA 30566 | 2007-03-12 |
| 1386619526 | Robert O Kelly | Family Medicine | 3931 Mundy Mill Rd., Oakwood, GA 30566 | 2006-02-21 |
| 1003464538 | Nichole Abernathy Hasan | Pharmacist | Walmart Pharmacy, 3827 Mundy Mill Rd, Oakwood, GA 30566 | 2019-08-28 |
| 1366808727 | Eye Site of Oakwood P.C. | Optometrist | 3640 Mundy Mill Road, Suite 146, Oakwood, GA 30566 | 2016-01-14 |
| Find all providers in zip 30566 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427667302 | Carole F Medou | Technician/Technologist | 57 Hurricane Shoals Rd Nw Ste A, Lawrenceville, GA 30046-5396 | 2020-07-28 |
| 1255966206 | Steven W Burton | Technician/Technologist | 2498 Wingfield Dr, Austell, GA 30106-1762 | 2020-03-10 |
| 1477185205 | Dale A Klauss | Technician/Technologist | 294 Kenwood Rd Ste A, Fayetteville, GA 30214-3451 | 2020-02-10 |
| 1104380682 | National Vision Inc | Technician/Technologist | 97 Parkway Dr, Fort Oglethorpe, GA 30742-4249 | 2019-01-29 |
| 1134683600 | National Vision Inc | Technician/Technologist | 3159 Highway 278 Ne, Covington, GA 30014-2301 | 2019-01-29 |
| 1255818993 | Kerryn Castellon | Technician/Technologist | 55 Sudderth St, Buford, GA 30518-3335 | 2018-07-25 |
| 1770075731 | National Vision, Inc. | Technician/Technologist | 916 Loganville Hwy Ste 300, Bethlehem, GA 30620-2145 | 2018-06-05 |
| 1598262487 | National Vision, Inc. | Technician/Technologist | 534 Marketplace Pkwy Ste 740, Dawsonville, GA 30534-7549 | 2018-04-09 |
| 1720582992 | Amos D Washington | Technician/Technologist | 10269 Industrial Blvd Ne, Covington, GA 30014-1485 | 2018-03-21 |
| 1619490489 | Lisa Stonebraker | Technician/Technologist | 105 E Main St Ste 116, Woodstock, GA 30188-5013 | 2017-07-24 |
| 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.