SAM'S CLUB OPTICAL (NPI# 1811094428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811094428 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6356 |
| Practice Address |
56 W Merritt Blvd Fishkill NY 12524-2243 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0235 |
| Practice Telephone | 8458964980 |
| Enumeration Date | 2006-09-19 |
| 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 30-6356 | 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 |
56 W MERRITT BLVD |
| City | FISHKILL |
| State | NY |
| Zip Code | 12524-2243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386602803 | Craig Nathanson | Optometrist | 56 W Merritt Blvd, Fishkill, NY 12524-2243 | 2006-05-03 |
| 1942483508 | Tina Truc Bo | Pharmacist | 56 W Merritt Blvd, Fishkill, NY 12524-2243 | 2007-12-06 |
| 1134146202 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 56 W Merritt Blvd, Fishkill, NY 12524-2243 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306392659 | Leandra Carr | Licensed Practical Nurse | 3 Mountain View Knolls Drive, Fishkill, NY 12524 | 2016-08-28 |
| 1558738427 | Teresa Williams | Speech-Language Pathologist | 51 Shirley Ave, Fishkill, NY 12524 | 2015-08-27 |
| 1689088742 | Cardiovascular and Medical Associate of The Hudson Valley PC | Internal Medicine | 841 Route 52 Suite 6, Fishkill, NY 12524 | 2014-06-17 |
| 1366876377 | Bohdan Darnobid | Physician Assistant | 121 Red School House Road, Fishkill, NY 12524 | 2013-08-27 |
| 1396007530 | Rebecca Gowans Roper-eckstein | Psychologist | 24 Old Glenham Road, Fishkill, NY 12524 | 2012-06-13 |
| 1083989859 | Nicos Nicolaou | Pathology | 400 Westage Business Ctr Dr Ste 209, Fishkill, NY 12524 | 2012-03-13 |
| 1760776256 | Janice Jacqueline Thomas-green | Registered Nurse | 62 Hoose Blvd, Fishkill, NY 12524 | 2011-06-02 |
| 1548494776 | Jacquelyn A Lindsay | Social Worker | 1575 Route 376 At New Hackensack Road, Wappingers Falls, NY 12524 | 2009-05-01 |
| 1154512838 | Joan J Miles | Registered Nurse | 74 Highland Ct, Fishkill, NY 12524 | 2007-08-07 |
| 1902097884 | Optical Fashions Corp | Technician/Technologist | 200 Westage Business Center Drive, Fishkill, NY 12524 | 2007-08-06 |
| Find all providers in zip 12524 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902097884 | Optical Fashions Corp | Technician/Technologist | 200 Westage Business Center Drive, Fishkill, NY 12524 | 2007-08-06 |
| 1841425766 | John Esposito | Technician/Technologist | 26 W Merritt Blvd, Fishkill, NY 12524-2243 | 2009-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982202628 | Smart Vision Care Inc. | Technician/Technologist | 5107 108th St # B, Corona, NY 11368-3304 | 2020-10-14 |
| 1396350757 | Galo Andrade II | Technician/Technologist | 123 State Route 94 S Ste 2, Warwick, NY 10990-3664 | 2020-09-12 |
| 1962016022 | Mathilde Brecy | Technician/Technologist | 248 Columbus Ave, New York, NY 10023-3331 | 2020-09-04 |
| 1417566258 | Neziah Maloney | Technician/Technologist | 43 President St, Huntington Station, NY 11746-2345 | 2020-07-28 |
| 1689290199 | Akeel Adil | Technician/Technologist | 9142 82nd St, Jamaica, NY 11421-2914 | 2020-06-20 |
| 1588289292 | Vision Express Optix Inc | Technician/Technologist | 98106 Queens Blvd, Rego Park, NY 11374-4354 | 2020-06-09 |
| 1942821749 | Frank Panzarella | Technician/Technologist | 364 Vermont St, Lindenhurst, NY 11757-5241 | 2020-05-03 |
| 1649806761 | Courtney Zhang | Technician/Technologist | 10204 Flatlands Avenue, Store 2906, Brooklyn, NY 11236 | 2020-03-20 |
| 1023644291 | Martha Canon | Technician/Technologist | 1440 Broadway # 10826, New York, NY 10018-2301 | 2020-03-19 |
| 1619500964 | Raphael Optical Inc. | Technician/Technologist | 303 Wyckoff Ave, Brooklyn, NY 11237-5805 | 2020-02-14 |
| 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.