SAM'S CLUB #4806 (NPI# 1891026001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891026001 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB #4806 |
| Other Organization Name | SAM'S OPTICA #4806 |
| Practice Address |
Carr #3 Km 15.2 Bo. Canovanilla Carolina PR 00979 |
| Mailing Address |
Carr#3 Km15.2 Bo. Canovanilla Carolina PR 00979 |
| Practice Telephone | 7874747278 |
| Practice Fax Number | 7877574795 |
| Mailing Telephone | 7874747278 |
| Mailing Fax Number | 7877574795 |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2010-01-28 |
| Authorized Official Name | MR. RENE PABON (RETAIL BUSINESS STRATEGIC DIRECTOR) |
| Authorized Official Telephone | 7876538094 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| Sam's Optica #4806 | Doing Business As Name - Organization |
| Street Address |
CARR #3 KM 15.2 BO. CANOVANILLA |
| City | CAROLINA |
| State | PR |
| Zip Code | 00979 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437769254 | Irma Cristina Acevedo | Psychologist | St. Palma De Sombrero #2, Urb. Villas Del Palmar Sur, Carolina, PR 00979 | 2020-08-06 |
| 1306468145 | Celia Rivera | Social Worker | 42 Calle Lucero, Urb. Los Angeles, Carolina, PR 00979 | 2020-05-14 |
| 1659922771 | Neyda Rosa Estremera | Technician | Condomino Waldorf Towers Apt. 1202, 4123 Ave. Isla Verde, Carolina, PR 00979 | 2019-09-20 |
| 1891351417 | Cesar G. Gerena Candal | General Practice | 1906 Cond Mundo Feliz, Carolina, PR 00979 | 2019-05-20 |
| 1770054298 | Movitaxi | Ambulance | 5870 Calle Tartak Apart 2104, Condominio Costa Del Sol, Carolina, PR 00979 | 2018-12-10 |
| 1720569973 | Soobin Maeng | General Practice | Condominio Playa Dorada Torres B Ph 12, Carolina, PR 00979 | 2018-08-26 |
| 1780170514 | Mayelin Amoros Duquesne | Internal Medicine | 5347 Ave Isla Verde, Marbella Oeste 1814, Carolina, PR 00979 | 2018-07-04 |
| 1851886741 | Carl L Palermo | Independent Medical Examiner | 7041 Calle 187 Apt 609a, Carolina, PR 00979 | 2018-06-25 |
| 1548753338 | Carol Stephanie Gonzalez | Psychologist | Isla Verde Mall, Avenida Los Gobernadores, Suite 218, Carolina, PR 00979 | 2018-06-07 |
| 1104323906 | Hospitalist Medical Services, Psc | Anesthesiology | Edificio Jesus T Pinero Ave Fernandez Juncos Bo Pueblo, Carolina, PR 00979 | 2018-04-09 |
| Find all providers in zip 00979 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578111043 | Shalem Consumer Brands | Eyewear Supplier (Equipment, not the service) | Avenida JesÚs M. Fragoso, Carolina, PR 00983 | 2019-08-28 |
| 1598268054 | Toperbee Corporation | Eyewear Supplier (Equipment, not the service) | 200 Ave Fragoso Ste 157, Carolina, PR 00983-3172 | 2018-03-12 |
| 1114453537 | Solo Optica 2 | Eyewear Supplier (Equipment, not the service) | Marginal Baldorioty De Castro Centro Comercial Laguna, Garden Suite 101-a, Carolina, PR 00979 | 2017-05-04 |
| 1558744375 | Maura Stabile | Eyewear Supplier (Equipment, not the service) | Calle Manuela Walker A-26 #2, Urb Rolling Hills, Carr 860, Carolina, PR 00987 | 2015-06-30 |
| 1629230321 | Professional Eye Care Inc | Eyewear Supplier (Equipment, not the service) | Carolina Shopp Ctr # 245, Fragoso Avenue, Carolina, PR 00985-5672 | 2008-06-25 |
| 1033324413 | Isis Fine Vision Services Inc | Eyewear Supplier (Equipment, not the service) | Via Mirta 3 Fs 1, Villa Fontana, Carolina, PR 00988-9419 | 2007-05-11 |
| 1518000579 | Insight Optical | Eyewear Supplier (Equipment, not the service) | Jesus Fragaso Ave Hwy 3 Loiza Hwy, Carolina, PR 00985 | 2007-02-15 |
| 1194870931 | Pearle Vision Center of Puerto Rico, Inc | Eyewear Supplier (Equipment, not the service) | Local 245, Plaza Carolina Mall 2nd Level, Carolina, PR 00988-9567 | 2007-01-24 |
| 1740334903 | Ohi of Puerto Rico, LLC | Eyewear Supplier (Equipment, not the service) | 157 Plaza Carolina, Baldorioty De Castro-exp, Carolina, PR 00985 | 2007-01-23 |
| 1770643264 | Lenscrafters International Inc | Eyewear Supplier (Equipment, not the service) | Fragoso Ave Expressway Loiza, Plaza Carolina, Carolina, PR 00983 | 2006-12-12 |
| Find all providers in CAROLINA | ||||
Please comment or provide details below to improve the information on SAM'S CLUB #4806.
| 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.