SAM'S CLUB OPTICAL (NPI# 1760584171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760584171 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6428 |
| Practice Address |
2950 Horseblock Rd Medford NY 11763-2525 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0235 |
| Practice Telephone | 6314470227 |
| Enumeration Date | 2006-09-05 |
| 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 30-6428 | 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 |
2950 HORSEBLOCK RD |
| City | MEDFORD |
| State | NY |
| Zip Code | 11763-2525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326065491 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 2950 Horseblock Rd, Medford, NY 11763-2543 | 2006-07-16 |
| 1306168281 | Mike C. Oh | Pharmacist | 2950 Horseblock Rd, Medford, NY 11763-2543 | 2010-02-19 |
| 1669610705 | Pamela M. Browne | Pharmacist | 2950 Horseblock Rd, Medford, NY 11763-2525 | 2009-01-28 |
| 1851571350 | Edmund Tam | Pharmacist | 2950 Horseblock Rd, Medford, NY 11763-2525 | 2007-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316572027 | Rebecca Molino | Specialist | 9, 3251 Ny-112 #2, Medford, NY 11763 | 2020-03-03 |
| 1295203677 | Hajar Taman | Pharmacist | 2975 Horseblock Road, Medford, NY 11763 | 2018-11-05 |
| 1265917041 | Bay Taxi Inc | Taxi | 36/94 Horseblock Rd, Medford, NY 11763 | 2018-09-27 |
| 1184108383 | Bay Taxi Inc | Taxi | 36/94 Horsblock Road, Medford, NY 11763 | 2018-09-24 |
| 1215419650 | Megan Bell | Speech-Language Pathologist | 135 Buffalo Avenue, Medford, NY 11763 | 2018-09-01 |
| 1922592906 | Elizabeth L Oakley | Specialist | 1 Sprat St, Medford, NY 11763 | 2018-06-21 |
| 1609383389 | Federation of Organizations for The New York State Mentally Disabled | Clinic/Center | 3390 Route 112 Ste B, Medford, NY 11763 | 2018-01-04 |
| 1497109607 | Tabitha Aitken | Massage Therapist | 28 Masem Ct, Medford, NY 11763 | 2016-04-14 |
| 1518326685 | Betty Velez | Specialist | 21 Red Pine Rd, Medford, NY 11763 | 2016-02-18 |
| 1134527054 | Angelo L D'esposito | Social Worker | 77 Robinson Ave, Medford, NY 11763 | 2014-12-09 |
| Find all providers in zip 11763 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417373507 | America's Best Contacts & Eyeglasses | Technician/Technologist | 930 Biddle Rd, Medford, OR 97504-6118 | 2014-03-13 |
| 1437272051 | Medford Eyeglass Shop Inc. | Technician/Technologist | 466 Salem St, Medford, MA 02155-3343 | 2007-04-09 |
| 1083738033 | S. H. Laufer Vision World | Technician/Technologist | 700 Patchogue Yaphank Rd Ste 20, Medford, NY 11763-2235 | 2007-03-16 |
| 1356486294 | Patricia Behrend | Technician/Technologist | 709 Stokes Road, Suite 100, Medford, NJ 08055-3002 | 2007-02-20 |
| 1184711632 | Wal-mart Stores, Inc | Technician/Technologist | 3615 Crater Lake Hwy, Medford, OR 97504-9259 | 2006-10-06 |
| 1811971203 | Eyeglass Service Industries | Technician/Technologist | 700 Route 101, 20, Medford, NY 11763-2206 | 2005-11-30 |
| 1790217826 | Ryvette Pagan | Technician/Technologist | 26 City Hall Mall, Medford, MA 02155-4754 | 2017-03-29 |
| 1205260148 | Wal-mart Stores Inc | Technician/Technologist | 3615 Crater Lake Hwy, Medford, OR 97504-9259 | 2013-08-28 |
| 1659635639 | Wal-mart Stores Inc | Technician/Technologist | 1360 Center Dr, Medford, OR 97501 | 2012-06-25 |
| 1437315314 | Group Rossetti Inc | Technician/Technologist | 21 High St, Medford, MA 02155 | 2008-07-31 |
| Find all providers in MEDFORD | ||||
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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.