SAM'S CLUB OPTICAL (NPI# 1558465989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558465989 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-8162 |
| Practice Address |
2605 Blairs Ferry Rd Ne Cedar Rapids IA 52402-1802 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0235 |
| Practice Telephone | 3192943360 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | TAMMY J BOYD (CONTRACT COORDINATOR) |
| Authorized Official Telephone | 4792771359 |
| 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 30-8162 | 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 |
2605 BLAIRS FERRY RD NE |
| City | CEDAR RAPIDS |
| State | IA |
| Zip Code | 52402-1802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811914203 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 2605 Blairs Ferry Rd Ne, Cedar Rapids, IA 52402-1802 | 2006-07-16 |
| 1255955126 | Debbie Sue Smith | Pharmacist | 2605 Blairs Ferry Rd Ne, Cedar Rapids, IA 52402-1802 | 2020-06-05 |
| 1700429511 | Linda S Kenny | Pharmacist | 2605 Blairs Ferry Rd Ne, Cedar Rapids, IA 52402-1802 | 2019-10-24 |
| 1619244787 | Copeland Eyecare Pllc | Optometrist | 2605 Blairs Ferry Rd Ne, Cedar Rapids, IA 52402-1802 | 2011-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639790520 | Sara Ann Rausch | Counselor | 1533 1 Ave Se, Cedar Rapids, IA 52402 | 2020-05-01 |
| 1558995589 | Jennifer Christine Hohneke | Nurse Practitioner | St. Luke's Transitional Care Center, 1420 Unitypoint Way, Cedar Rapids, IA 52402 | 2020-02-28 |
| 1073008314 | Benjamin Randall Groth | Optometrist | 576 Boyson Rd Ne Ste 104, Cedar Rapids, IA 52402 | 2018-06-28 |
| 1992228621 | Synona Culbertson | Counselor | 4403 1st Ave Ne, Suite L15, Cedar Rapids, IA 52402 | 2017-07-25 |
| 1083136410 | Compassion North America Home Health Services Corp | Hospice Care, Community Based | 1570 42nd Street Ne, Suite #2a, Cedar Rapids, IA 52402 | 2017-07-07 |
| 1861819732 | Arj Infusion Services, Inc. | Home Infusion | 1847 First Ave Se, Suite 100, Cedar Rapids, IA 52402 | 2014-03-27 |
| 1639475197 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 4444 1st Ave Ne Ste 575, Cedar Rapids, IA 52402 | 2011-02-01 |
| 1437452919 | Empowering Families Inc | Early Intervention Provider Agency | 5005 Blairsforest Way, Cedar Rapids, IA 52402 | 2010-12-06 |
| 1184937476 | Jennifer Becker | Counselor | 3745 Center Point Rd Ne Ste A, Cedar Rapids, IA 52402 | 2010-07-15 |
| 1215179817 | William H Fletcher | Hearing Instrument Specialist | 3741 Center Point Rd Ne, Cedar Rapids, IA 52402 | 2009-03-27 |
| Find all providers in zip 52402 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790013217 | America's Best Contacts & Eyeglasses | Technician/Technologist | 3005 Wiley Blvd Sw Ste 114, Cedar Rapids, IA 52404-3178 | 2009-11-20 |
| 1508059866 | Kari Ozburn | Technician/Technologist | 4330 Czech Ln Ne, Cedar Rapids, IA 52402-2334 | 2007-08-21 |
| 1891988150 | Elaine Baily | Technician/Technologist | 4330 Czech Ln Ne, Cedar Rapids, IA 52402-2334 | 2007-08-21 |
| 1275614091 | Wal-mart Stores, Inc. | Technician/Technologist | 2645 Blairs Ferry Rd Ne, Cedar Rapids, IA 52402-1802 | 2006-10-18 |
| 1154402204 | Wal-mart Stores, Inc. | Technician/Technologist | 3601 29th Ave Sw, Cedar Rapids, IA 52404-3109 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508341843 | Robin Christine Singleton | Technician/Technologist | 103 2nd St Se, Altoona, IA 50009-1809 | 2018-10-02 |
| 1689087538 | Innovative Ear & Hearing | Technician/Technologist | 1620 Jfk Rd, Dubuque, IA 52002-5302 | 2014-06-09 |
| 1942645056 | John Robert Jansen | Technician/Technologist | 613 G Ave, Grundy Center, IA 50638 | 2013-05-02 |
| 1891000147 | Wal-mart Stores Inc | Technician/Technologist | 2150 East 1st St., Grimes, IA 50111 | 2010-08-11 |
| 1992025399 | America's Best Contacts & Eyeglasses | Technician/Technologist | 2515 Nw Arterial Ste 2, Dubuque, IA 52002-0400 | 2010-06-08 |
| 1720316243 | America's Best Contacts & Eyeglasses | Technician/Technologist | 3701 Metro Dr Ste 400, Council Bluffs, IA 51501-7738 | 2009-11-20 |
| 1447404256 | America's Best Contacts & Eyeglasses | Technician/Technologist | 5717 Elmore Ave Ste C, Davenport, IA 52807-3514 | 2008-11-06 |
| 1720232531 | America's Best Contacts & Eyeglasses | Technician/Technologist | 1805 Se Delaware Ave Ste 900, Ankeny, IA 50021-3935 | 2008-11-06 |
| 1316123763 | Us Vision Optical Inc | Technician/Technologist | 3333 Market Place Dr, Council Bluffs, IA 51501-8287 | 2008-01-16 |
| 1548483639 | Russ Uptown Optical Inc | Technician/Technologist | 4122 University Ave, Des Moines, IA 50311-3533 | 2007-04-10 |
| Find all providers with the same taxonomy | ||||
| City | CEDAR RAPIDS |
| Zip Code | 52402 |
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.