SAM'S CLUB OPTICAL (NPI# 1720174550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720174550 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6650 |
| Practice Address |
6410 Petrie Way Rd Baltimore MD 21237-3034 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 4106862683 |
| Enumeration Date | 2006-10-05 |
| 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 30-6650 | 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 |
6410 PETRIE WAY RD |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21237-3034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225666977 | Sheena Alisha Abraham | Nurse Anesthetist, Certified Registered | Medstar Franklin Square Medical Center, 9000 Franklin Square Drive, Baltimore, MD 21237 | 2020-03-30 |
| 1295221281 | Anyelin Almanzar | Student in an Organized Health Care Education/Training Program | 900 Franklin Square Dr, Dept. of General Surgery, Baltimore, MD 21237 | 2018-07-03 |
| 1952894818 | Peace Healthcare | Home Health | 8683 Old Philadelphia Road, Rosedale, MD 21237 | 2018-06-14 |
| 1134621816 | Maryland Sportscare & Rehab LLC | Physical Therapist | 8665 Pulaski Hwy Ste 115, Rosedale, MD 21237 | 2018-03-08 |
| 1619480308 | Valorie Elaine Colby | Registered Nurse | Eastern Family Resource Center, 9150 Franklin Square Drive, Rosedale, MD 21237 | 2017-11-16 |
| 1891205910 | Gidez Nursing Services LLC | Registered Nurse | 8902 Lennings Lane, Baltimore, MD 21237 | 2017-10-03 |
| 1801258736 | Riverside Treatment Services LLC | Clinic/Center | 8359 Pulaski Highway, Rosedale, MD 21237 | 2016-03-21 |
| 1457734691 | Ati Holdings, LLC | Occupational Therapist | 8652 Pulasky Hwy Ste C-1, Rosedale, MD 21237 | 2015-07-07 |
| 1063802940 | Melissa Pollard | Pharmacy Technician | 1521 Seling Ave, Baltimore, MD 21237 | 2015-01-29 |
| 1053733378 | Thrive Behavioral Health, LLC | Community/Behavioral Health | 9627 Philadelphia Rd Ste 160, Rosedale, MD 21237 | 2014-01-07 |
| Find all providers in zip 21237 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952969503 | Catonsville Vision Partners | Technician/Technologist | 405 Frederick Rd Ste 106, Baltimore, MD 21228-4646 | 2019-05-30 |
| 1215436357 | National Vision. Inc. | Technician/Technologist | 1401 Merritt Blvd # F, Baltimore, MD 21222-2140 | 2018-02-05 |
| 1972017358 | Chippewa Optical LLC | Technician/Technologist | 305 Reisterstown Rd, Baltimore, MD 21208-5313 | 2017-11-21 |
| 1396271433 | Harry Floyd Eichner | Technician/Technologist | 1005 N Point Blvd Ste 704, Baltimore, MD 21224-3402 | 2017-05-11 |
| 1821322710 | Patrick Kelly | Technician/Technologist | 1490 W Patapsco Ave, Baltimore, MD 21230-3400 | 2009-09-24 |
| 1396989265 | America's Best Contacts & Eyeglasses | Technician/Technologist | 1374 Martin Blvd, Baltimore, MD 21220-4104 | 2009-04-23 |
| 1124268156 | America's Best Contacts & Eyeglasses | Technician/Technologist | 300 W Lexington St, Baltimore, MD 21201-3418 | 2009-03-04 |
| 1851566467 | David Kenneth Jackson | Technician/Technologist | 4200 Elderon Ave, Baltimore, MD 21215-4802 | 2008-04-24 |
| 1356541783 | Carolyn Renee Player | Technician/Technologist | 837 N Howard St, 2nd Floor, Baltimore, MD 21201-4699 | 2007-07-24 |
| 1215058961 | Jeffrey Alan Harris | Technician/Technologist | 220 N Basil St, Baltimore, OH 43105-1004 | 2007-04-02 |
| Find all providers in BALTIMORE | ||||
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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.