SAM'S CLUB OPTICAL (NPI# 1871696906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871696906 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6373 |
| Practice Address |
1100 Grand Central Ave Vienna WV 26105-1049 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 3042950280 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LINDA M. EPPERSON (NPI COORDINATOR) |
| Authorized Official Telephone | 3167888850 |
| 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 30-6373 | 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 |
1100 GRAND CENTRAL AVE |
| City | VIENNA |
| State | WV |
| Zip Code | 26105-1049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922609502 | Jessie Elizabeth Myers | Pharmacist | 1100 Grand Central Ave, Vienna, WV 26105-1049 | 2020-11-02 |
| 1275133902 | Lisa Stephens | Pharmacist | 1100 Grand Central Ave, Vienna, WV 26105-1049 | 2020-10-30 |
| 1669072609 | Cynthia Elaine Brown | Pharmacist | 1100 Grand Central Ave, Vienna, WV 26105-1049 | 2020-10-29 |
| 1942575808 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 1100 Grand Central Ave, Vienna, WV 26105-1049 | 2012-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023536596 | Medexpress Urgent Care, PC - Virginia | Emergency Medicine | 3 Merrywood Lane, Vienna, WV 26105 | 2017-09-06 |
| 1558889196 | Medexpress Urgent Care, PC - Virginia | Emergency Medicine | 2 Merrywood Lane, Vienna, WV 26105 | 2017-09-05 |
| 1538555206 | Cecilia Velarde Harrington | Internal Medicine | 418 Grand Park Dr Ste 311, Parkersburg, WV 26105 | 2015-04-09 |
| 1568854974 | Kathryn Eileen Epkey | Student in an Organized Health Care Education/Training Program | 411 28th Street, Vienna, WV 26105 | 2015-02-21 |
| 1023120441 | Robert William Azar | Otolaryngology | 1801 Grand Central Ave, Vienna, WV 26105 | 2006-08-31 |
| 1578521407 | John A Stavrakis | Optometrist | 701 Grand Central Ave, Vienna, WV 26105 | 2006-05-02 |
| 1881203149 | Charlene Rein | Dentist | 501 Grand Central Ave, Vienna, WV 26105 | 2020-07-23 |
| 1891355434 | Mohamed Moustafa Meky | Dentist | 501 Grand Central Ave, Parkersburg, WV 26105 | 2019-06-17 |
| 1710469606 | Karen Malee Palmateer | Physician Assistant | 800 Grand Central Mall, Mov Medical Office Building, Suite 10, Vienna, WV 26105 | 2018-09-06 |
| 1568990091 | Jonathon Ray Barbosa Scott | Specialist/Technologist | 1 Campus Drive, Vienna, WV 26105 | 2017-05-29 |
| Find all providers in zip 26105 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972117372 | Martin A Shahmirzadi | Technician/Technologist | 1934 Old Gallows Rd Ste 350b, Vienna, VA 22182-4042 | 2020-09-02 |
| 1275730525 | Tysons Corner Opticians Inc | Technician/Technologist | 8150 Leesburg Pike, Suite 901, Vienna, VA 22182-7715 | 2007-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528148 | Jordan Renee Morrison | Technician/Technologist | 139 Conference Center Way Ste 121, Bridgeport, WV 26330-9147 | 2020-11-05 |
| 1154585941 | Mary Jane Tudor | Technician/Technologist | 834 Robert C Byrd Drive Unit B, Sophia, WV 25921 | 2008-07-11 |
| 1871763862 | Wayne Dougherty Dba Wheeling Optical | Technician/Technologist | 1101 Market Street, Wheeling, WV 26003-2905 | 2008-03-05 |
| 1629257522 | Robert Martin Mustard II | Technician/Technologist | 210 1/2 North Street, Bluefield, WV 24701 | 2007-10-26 |
| 1033240429 | Wal-mart Stores East, L.p. | Technician/Technologist | 1 Tygart Valley Mall, Fairmont, WV 26554-3430 | 2007-03-08 |
| 1588711873 | Melvin Leroy Mckinney Sr. | Technician/Technologist | 605 Bland St, Bluefield, WV 24701 | 2007-01-05 |
| 1922178474 | Tea Vision Inc | Technician/Technologist | 5 Putnam Villiage, Teays, WV 25569 | 2006-11-09 |
| 1356410849 | Jennifer L Field | Technician/Technologist | 10565 Veterans Memorial Highway, Masontown, WV 26542-9577 | 2006-11-07 |
| 1598841827 | Wal-mart Stores East, Lp | Technician/Technologist | 6051 University Town Centre Dr., Morgantown, WV 26534 | 2006-10-30 |
| 1235210212 | Wal-mart Stores East, Lp | Technician/Technologist | 1881 Robert C Byrd Dr, Beckley, WV 25801-8355 | 2006-10-18 |
| 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.