SAM'S CLUB OPTICAL (NPI# 1427159961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427159961 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6319 |
| Practice Address |
4326 28th St Se Kentwood MI 49512-1908 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 6169422656 |
| Enumeration Date | 2006-09-26 |
| 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 30-6319 | 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 |
4326 28TH ST SE |
| City | KENTWOOD |
| State | MI |
| Zip Code | 49512-1908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093732216 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 4326 28th St Se, Kentwood, MI 49512-1908 | 2006-07-16 |
| 1477153096 | Kenzee Turner | Pharmacist | 4326 28th St Se, Kentwood, MI 49512-1908 | 2020-11-01 |
| 1639657109 | Stephen John Nass | Pharmacist | 4326 28th St Se, Kentwood, MI 49512-1908 | 2018-08-06 |
| 1669830089 | Nicole Lam | Pharmacist | 4326 28th St Se, Kentwood, MI 49512-1908 | 2016-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649757071 | St. Lukes Primary Care | Family Medicine | 5300 Patterson Ave Se Ste 1-d, Grand Rapids, MI 49512 | 2018-07-27 |
| 1013493733 | Pharmascript of Michigan Gr LLC | Pharmacy | 2661 29th St. Se Suite A, Grand Rapids, MI 49512 | 2018-07-16 |
| 1245736040 | Cassandra Slater | Technician, Other | 2925 Breton Rd Se, Grand Rapids, MI 49512 | 2018-04-02 |
| 1235632704 | John Mitchell Tanja | Occupational Therapist | 3350 Broadmoor Avenue Se, Grand Rapids, MI 49512 | 2018-03-12 |
| 1952829855 | Sarah Harlow | Physical Therapist | 2951 44th St Se, Kentwood, MI 49512 | 2017-08-31 |
| 1194248815 | Melinda Huizenga | Registered Nurse | 5300 Patterson Ave Se Ste 125, Grand Rapids, MI 49512 | 2017-07-25 |
| 1659812931 | Frantzie Pierre | Counselor | 3300 S Creek Dr Se Apt 201, Kentwood, MI 49512 | 2017-03-20 |
| 1104128602 | Hope Network Behavioral Health Services | Psychiatry & Neurology | 3361 36th Street, Grand Rapids, MI 49512 | 2010-12-03 |
| 1518282631 | Melanie Anne Hogeterp | Social Worker | 3180 East Paris Se, Kentwood, MI 49512 | 2010-03-31 |
| 1013147495 | Ardean Beth Brock-vanderwall | Counselor | 2828 Kraft Ave., Grand Rapids, MI 49512 | 2009-07-20 |
| Find all providers in zip 49512 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588201420 | William Wise | Technician/Technologist | 410 North St, Otisville, MI 48463-9705 | 2019-12-10 |
| 1033750658 | American Eye Institute Optical Inc | Technician/Technologist | 2300 Haggerty Rd Ste 1100, West Bloomfield, MI 48323-2185 | 2019-10-04 |
| 1225595705 | National Vision Inc | Technician/Technologist | 1328 S Rochester Rd, Rochester Hills, MI 48307-3124 | 2019-02-21 |
| 1184191306 | National Vision Inc | Technician/Technologist | 50697 Waterside Dr, Chesterfield, MI 48051-4008 | 2018-10-25 |
| 1275045916 | W. Optical 4 LLC | Technician/Technologist | 1004 28th St Sw, Wyoming, MI 49509-2881 | 2017-11-03 |
| 1164932489 | Salim Rufo Auraha | Technician/Technologist | 3747 15 Mile Rd, Sterling Heights, MI 48310-5358 | 2017-10-02 |
| 1720527955 | Wal-mart Stores East, Lp | Technician/Technologist | 2755 W Holton-whitehall Rd, Whitehall, MI 49461 | 2017-02-21 |
| 1811434293 | Joseph Frye-dandridge | Technician/Technologist | 18669 Oakfield St, Detroit, MI 48235-3060 | 2017-01-24 |
| 1689110710 | W. Optical 2 LLC | Technician/Technologist | 3233 Alpine Ave Nw Ste A, Grand Rapids, MI 49544-1631 | 2017-01-12 |
| 1811377740 | Kat Stannis LLC | Technician/Technologist | 1794 N Old Us 23, Howell, MI 48843-7193 | 2015-06-05 |
| 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.