SAM'S CLUB OPTICAL (NPI# 1508957721) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508957721 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-4830 |
| Practice Address |
1459 N Dysart Rd Avondale AZ 85323-1515 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 6238823859 |
| Enumeration Date | 2006-09-27 |
| 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 30-4830 | 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 |
1459 N DYSART RD |
| City | AVONDALE |
| State | AZ |
| Zip Code | 85323-1515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417974635 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 1459 N Dysart Rd, Avondale, AZ 85323-1515 | 2006-07-16 |
| 1871971721 | Amara Gudger | Pharmacist | 1459 N Dysart Rd, Avondale, AZ 85323-1515 | 2015-05-12 |
| 1164845442 | Heather Bartelt | Pharmacist | 1459 N Dysart Rd, Avondale, AZ 85323-1515 | 2014-01-22 |
| 1043429574 | Nita Catt | Optometrist | 1459 N Dysart Rd, Inside Sams Club, Avondale, AZ 85323-1515 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932663994 | Bridgewater Avondale Operations, LLC | Assisted Living Facility | 295 E Van Buren Street, Avondale, AZ 85323 | 2019-01-24 |
| 1104309152 | Carlos Sifuentes | Physical Therapist | 10750 W Mcdowell Rd., Ste. B-210, Avondale, AZ 85323 | 2018-09-14 |
| 1225534688 | Dayna Sue Kaepp | Registered Nurse | 3300 N. Santa Fe Trail, Avondale, AZ 85323 | 2018-04-04 |
| 1407376700 | Amanda Lynn Radcliffe | Nurse Practitioner | 824 N. 99th Ave Ste 108, Avondale, AZ 85323 | 2017-06-27 |
| 1093253361 | Aquatic-n-writing Rehad | Home Health | 12355 West Cocopah Street, Avondale, AZ 85323 | 2017-02-07 |
| 1750838348 | Annette A Alvarez | Specialist/Technologist | 295 W Western Avenue, Avondale, AZ 85323 | 2016-09-01 |
| 1649726886 | Michelle R Dotson | Contractor | 12115 W Van Buren St Apt 1924, Avondale, AZ 85323 | 2016-08-28 |
| 1619370756 | Amanda Mann | Physical Therapy Assistant | 12804 West Hildalgo, Avondale, AZ 85323 | 2014-10-03 |
| 1326459306 | Ma Caubalejo | Physical Therapist | 350 East La Canada Blvd, Avondale, AZ 85323 | 2014-05-13 |
| 1093139545 | Mark Salvador | Physical Therapy Assistant | 11722 W. Mountain View Dr., Avondale, AZ 85323 | 2014-02-04 |
| Find all providers in zip 85323 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992893036 | Walmart Stores, Inc. | Technician/Technologist | 13055 W Rancho Santa Fe Blvd, Avondale, AZ 85323-1700 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043827389 | Sabina Krasnov | Technician/Technologist | 8300 N Hayden Rd Ste B112, Scottsdale, AZ 85258-2538 | 2020-09-30 |
| 1093351611 | Nationwide Vision Center, LLC | Technician/Technologist | 7650 S 59th Ave, Suite 101, Laveen, AZ 85339 | 2019-11-19 |
| 1326519125 | National Vision Inc | Technician/Technologist | 7470 W Bell Rd Ste 206, Glendale, AZ 85308-8532 | 2018-12-06 |
| 1932677713 | National Vision Inc | Technician/Technologist | 9340 W Northern Ave Ste 120, Glendale, AZ 85305-1148 | 2018-11-09 |
| 1871074971 | National Vision, Inc. | Technician/Technologist | 7670 S Priest Dr, Tempe, AZ 85284-1001 | 2018-08-27 |
| 1790264695 | Hossain Basiri | Technician/Technologist | 15090 N Northsight Blvd Ste 105, Scottsdale, AZ 85260-2609 | 2018-08-10 |
| 1134608631 | National Vision Inc | Technician/Technologist | 4320 E Cactus Rd, Phoenix, AZ 85032-7636 | 2018-08-07 |
| 1316425531 | Nationwide Vision Center, LLC | Technician/Technologist | 85 Lake Havasu Ave N, Suite 108, Lake Havasu City, AZ 86403-5698 | 2018-07-31 |
| 1033695978 | National Vision Inc | Technician/Technologist | 2651 N 44th St Ste 2, Phoenix, AZ 85008-1574 | 2018-07-13 |
| 1659866564 | National Vision, Inc. | Technician/Technologist | 1438 S Power Rd Ste 101, Mesa, AZ 85206-3729 | 2018-06-25 |
| 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.