SAM'S CLUB OPTICAL (NPI# 1902920093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902920093 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30- |
| Practice Address |
4400 North Main St Roswell NM 88201 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-6209 |
| Practice Telephone | 5056279852 |
| Mailing Telephone | 4792771703 |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. NORMA B SMITH (MPI ASSOCIATE) |
| Authorized Official Telephone | 4792771703 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| Sam's Club Optical 30- | 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 |
4400 NORTH MAIN ST |
| City | ROSWELL |
| State | NM |
| Zip Code | 88201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902310022 | Corey A Carter | Specialist/Technologist, Other | 117 E 19th Street, Roswell, NM 88201 | 2017-11-28 |
| 1326598541 | Dove Medical Corporation | Family Medicine | 110 East 3rd Street, Roswell, NM 88201 | 2016-10-12 |
| 1841748381 | Anali Velez | Registered Nurse | 300 N Kentucky, Roswell, NM 88201 | 2016-09-13 |
| 1831647379 | Rebecca Palomino | Registered Nurse | 800 Marion Richards Rd, Roswell, NM 88201 | 2016-09-13 |
| 1215300926 | Heart Path Oriental Medicine | Clinic/Center | 810 N Union, Roswell, NM 88201 | 2015-11-03 |
| 1538564745 | Lacey Scott | Pharmacist | 1835 N. Main, Roswell, NM 88201 | 2014-10-30 |
| 1962815852 | Marium Khan | Internal Medicine | 400 Military Heights Place, Roswell, NM 88201 | 2014-06-09 |
| 1316288913 | Anaya Counseling | Community/Behavioral Health | 613 W 2nd St Ste 4, Roswell, NM 88201 | 2013-03-06 |
| 1205185386 | Rosarita Brady | Occupational Therapist | 300 N. Kentucky, Roswell, NM 88201 | 2012-09-05 |
| 1922360049 | Ashley Spinhirne Thompson | Speech-Language Pathologist | 304 N. Richardson, Roswell, NM 88201 | 2012-06-14 |
| Find all providers in zip 88201 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518084961 | Edward T. Kleinman | Technician/Technologist | 10800 Alpharetta Hwy, Suite 220, Roswell, GA 30076-1490 | 2007-03-23 |
| 1972038933 | Gazal Eyecare | Technician/Technologist | 76 Norcross St, Suite B, Roswell, GA 30075-3866 | 2017-04-27 |
| 1295177632 | John Brent Seilheimer | Technician/Technologist | 107 W 6th St, Roswell, NM 88201-4801 | 2013-07-26 |
| 1912108119 | Eye Optique, Inc. | Technician/Technologist | 10800 Alpharetta Hwy, Suite 220, Roswell, GA 30076-1490 | 2007-05-29 |
| 1154459006 | Pro-optical Express Ltd. | Technician/Technologist | 207 N Union Ave, Roswell, NM 88201-3068 | 2007-03-01 |
| 1770673386 | Wal-mart Stores East, Lp | Technician/Technologist | 970 Mansell Rd, Roswell, GA 30076-1506 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477187912 | Jacqueline Rodriguez | Technician/Technologist | 1110 Vuelta De Las Acequias, Santa Fe, NM 87507-7105 | 2020-02-24 |
| 1275056186 | Marie Angela Archibeque | Technician/Technologist | 2910 San Mateo Blvd Ne Ste 6, Albuquerque, NM 87110-3187 | 2017-07-23 |
| 1558882910 | Norma Karram | Technician/Technologist | 1300 W Maloney Ave Ste 208, Gallup, NM 87301-3325 | 2017-07-06 |
| 1295188050 | Vista Optical | Technician/Technologist | 102 W Octagon St, Bldg 77b, Cannon Afb, NM 88103-5207 | 2016-07-18 |
| 1649619511 | National Vision Optical | Technician/Technologist | 7901 Gibson Blvd, Bldg 20176, Kirtland, NM 87117 | 2013-06-24 |
| 1437403359 | National Vision Optical | Technician/Technologist | Main Exchange Bldg. 260, White Sands Missile Range, NM 88002 | 2012-10-30 |
| 1548541204 | Roberta Jean Montoya I | Technician/Technologist | 3905 Isleta Blvd Sw, Albuquerque, NM 87105-6130 | 2011-09-07 |
| 1144534892 | Kathryn Branch Casey | Technician/Technologist | 1101 State Road 1, Socorro, NM 87801-5004 | 2010-08-04 |
| 1629396015 | Lorraine Gomez | Technician/Technologist | 4201 Central Ave Ne, #b2, Albuquerque, NM 87105-1630 | 2010-05-10 |
| 1043534209 | Ray J Montoya | Technician/Technologist | 1908 N Prince St, Clovis, NM 88101-4857 | 2010-03-17 |
| 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.