SAM'S CLUB OPTICAL (NPI# 1841381415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841381415 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-4840 |
| Practice Address |
3900 Deerfield Dr. Janesville WI 53546 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0235 |
| Practice Telephone | 6087412397 |
| Enumeration Date | 2006-09-27 |
| 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 30-4840 | 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 |
3900 DEERFIELD DR. |
| City | JANESVILLE |
| State | WI |
| Zip Code | 53546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366911489 | Latoya Christina Anderson | Counselor | 1818 Pershing Pl, Janesville, WI 53546 | 2018-11-19 |
| 1922599216 | Megan Arney | Speech-Language Pathologist | 9680, 4445 Woodgate Dr., Janesville, WI 53546 | 2018-05-23 |
| 1770089955 | Abby Marie Harnack | Registered Nurse | 3901 Teal Ln, Janesville, WI 53546 | 2018-04-05 |
| 1962773648 | Clark Carroll | Nurse Practitioner | 1820 Center Ave, Janesville, WI 53546 | 2012-01-26 |
| 1689983793 | Fve Mw LLC | Assisted Living Facility | 3801 North Wright Road, Janesville, WI 53546 | 2010-10-07 |
| 1831354794 | County of Rock County Clerk | Community/Behavioral Health | 3506 Hwy 51, Janesville, WI 53546 | 2008-07-21 |
| 1528225422 | Walgreen Co | Pharmacy | 2519 Kettering St, Janesville, WI 53546 | 2008-05-19 |
| 1447420351 | Michele Renee Bohland | Physical Therapy Assistant | 2540 Humes Rd, Janesville, WI 53546 | 2008-03-06 |
| 1093992158 | Emma Gene Harrell | Counselor | 203 W Sunny Lane, Janesville, WI 53546 | 2008-01-30 |
| 1457473696 | Robert Louis Fleming | Dentist | 910 Conde St, Janesville, WI 53546 | 2007-04-06 |
| Find all providers in zip 53546 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548308745 | Wisconsin Vision, Inc | Technician/Technologist | 2929 Milton Ave, Janesville, WI 53545-0253 | 2007-02-01 |
| 1265562813 | Vision Mart Inc | Technician/Technologist | 1717 Center Ave, Janesville, WI 53546-2800 | 2007-03-06 |
| 1053496976 | Wal-mart Stores East, Lp | Technician/Technologist | 3800 Deerfield Dr, Janesville, WI 53545 | 2006-10-26 |
| 1427166164 | Us Vision Optical Inc | Technician/Technologist | 2500 Milton Ave, Janesville, WI 53545-0452 | 2006-08-25 |
| 1659393627 | Us Vision Optical Inc | Technician/Technologist | 2500 Milton Ave, Janesville, WI 53545-0452 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336782986 | Penny S Zaworski | Technician/Technologist | 806 N Old World 3rd St, Milwaukee, WI 53203-1701 | 2019-10-25 |
| 1326518002 | Robert Bailen | Technician/Technologist | 207 2nd Ave W, Ashland, WI 54806-1605 | 2018-11-26 |
| 1972051373 | Sam's East, Inc. | Technician/Technologist | 8100 N 124th Street, Milwaukee, WI 53223 | 2016-09-14 |
| 1568835544 | Jolanda Burnett | Technician/Technologist | 1645 N Central Ave, Marshfield, WI 54449-1550 | 2015-11-12 |
| 1467865857 | America's Best Contacts & Eyeglasses | Technician/Technologist | 9074 N Green Bay Rd, Brown Deer, WI 53209-1205 | 2014-06-04 |
| 1376882613 | Design Vision, Inc. | Technician/Technologist | 8720 W North Ave, Wauwatosa, WI 53226-2724 | 2013-02-06 |
| 1518259407 | Faces Eyewear, Inc | Technician/Technologist | 10 E College Ave, Appleton, WI 54911-5756 | 2011-05-10 |
| 1598073108 | Wal-mart Stores East Lp | Technician/Technologist | W159 S6530 Moorland, Muskego, WI 53150 | 2010-09-16 |
| 1285953794 | America's Best Contacts & Eyeglasses | Technician/Technologist | 8661 S Howell Ave Ste 200, Oak Creek, WI 53154-2919 | 2010-05-24 |
| 1053553453 | Lisa Cuda Mccarron | Technician/Technologist | 5500 E Cheryl Pkwy, Suite 103, Fitchburg, WI 53711-5336 | 2009-03-31 |
| Find all providers with the same taxonomy | ||||
| City | JANESVILLE |
| Zip Code | 53546 |
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.