SAM'S CLUB OPTICAL (NPI# 1902982747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902982747 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-8195 |
| Practice Address |
69 Pavilion Dr Manchester CT 06042-8702 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-6209 |
| Practice Telephone | 8606445593 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LINDA M. EPPERSON (NPI COORDINATOR) |
| Authorized Official Telephone | 3167885580 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers | ||
| X | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| Sam's Club Optical 30-8195 | 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 |
69 PAVILION DR |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06042-8702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336301597 | Sidet Sou, Od, LLC | Optometrist | 69 Pavilion Dr, Manchester, CT 06042-8702 | 2008-06-30 |
| 1053452169 | Thomas James Ptachcinski | Pharmacist | 69 Pavilion Dr, Manchester, CT 06042-8702 | 2007-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275000960 | Nicole Berger | Behavioral Analyst | 199 Tudor Lane, Apartment E, Manchester, CT 06042 | 2018-10-31 |
| 1902336522 | Karen Scandura | Pharmacist | 260 North Main Street, Manchester, CT 06042 | 2017-06-15 |
| 1053727479 | Sph3enterprise, LLC | Dentist | 194 Buckland Hills Drive, Manchester, CT 06042 | 2014-07-07 |
| 1962657288 | Anthony Michael Gioscia | Optometrist | 344v Buckland Hills Dr, Manchester, CT 06042 | 2008-12-01 |
| 1467635714 | Linda Fernald Gates | Dietitian, Registered | 300 Parker St, Manchester, CT 06042 | 2007-12-10 |
| 1669513909 | Carlos Alfonso Gonzalez | Psychiatry & Neurology | 317 North Main Street, C/o Ccgc, Manchester, CT 06042 | 2007-02-09 |
| 1942350467 | Lise G. O'neill | Counselor | Manchester Memorial Hospital, 71 Haynes St, Manchester, CT 06042 | 2007-01-10 |
| 1558439398 | Jason Allen Sousa | Chiropractor | 1127 Tolland Turnpike, Suite 102, Manchester, CO 06042 | 2006-12-01 |
| 1245332444 | Sharon Soria | Dentist | 192 Main Street, Manchester, TN 06042 | 2006-09-01 |
| 1699732206 | First Choice Health Centers, Inc. | Clinic/Center | 150 N Main St Ste 240, Manchester, CT 06042 | 2006-04-27 |
| Find all providers in zip 06042 | ||||
| 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 |
|---|---|---|---|---|
| 1215535455 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 1046 Tolland Tpke, Manchester, CT 06042-1655 | 2020-10-10 |
| 1740335207 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 194 Buckland Hills Dr, Manchester, CT 06042-8705 | 2007-01-24 |
| 1124172176 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 6 March Ave, Manchester, NH 03103 | 2007-01-23 |
| 1639232580 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 575 S Willow St, Manchester, NH 03103-5713 | 2006-12-19 |
| 1891869178 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 200 John E Devine Dr, Manchester, NH 03103-4033 | 2006-11-20 |
| 1104836642 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 344 Buckland Hills Dr 7000, Manchester, CT 06040 | 2006-08-08 |
| 1659979714 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 200 John E Devine Dr, Manchester, NH 03103-4033 | 2020-10-12 |
| 1104217850 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 301 Highlands Boulevard Dr, Manchester, MO 63011-4385 | 2015-02-16 |
| 1942539879 | Pearle Vision Inc | Eyewear Supplier (Equipment, not the service) | 575 S Willow St, Manchester, NH 03103-5713 | 2009-12-24 |
| 1023164811 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 1500 S Willow St, The Mall of New Hampshire, Manchester, NH 03103-3220 | 2007-01-26 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 06042 |
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.