SAM'S CLUB OPTICAL (NPI# 1912094236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912094236 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6333 |
| Practice Address |
47 Haskell Rd Bangor ME 04401-4229 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-6209 |
| Practice Telephone | 2079474606 |
| Enumeration Date | 2006-10-06 |
| 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 | 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 30-6333 | 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 |
47 HASKELL RD |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-4229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457378721 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 47 Haskell Rd, Bangor, ME 04401-4229 | 2006-07-16 |
| 1316424385 | Holly Dunning | Pharmacist | 47 Haskell Rd, Bangor, ME 04401-4229 | 2018-07-23 |
| 1871079285 | Brian Hackett | Pharmacist | 47 Haskell Rd, Bangor, ME 04401-4229 | 2018-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760856504 | Usv Optical Inc. | Technician/Technologist | 164 Longview Dr, Bangor, ME 04401-3631 | 2015-11-17 |
| 1265759773 | Camkay | Technician/Technologist | 336 Mthope Ave, Bangor, ME 04401 | 2010-04-23 |
| 1730370420 | John Stanton Macinnes | Technician/Technologist | 885 Union Street, Suite 140, Bangor, ME 04401-3082 | 2007-08-07 |
| 1104373265 | Heavenly Vision | Technician/Technologist | 455 Blue Valley Dr, Bangor, PA 18013 | 2016-09-07 |
| 1881059293 | Timothy James Velekei Sr. | Technician/Technologist | 455 Blue Valley Dr, Bangor, PA 18013 | 2015-12-30 |
| 1881866085 | Macinnes Optical | Technician/Technologist | 885 Union St, Ste 140, Bangor, ME 04401-3082 | 2008-03-27 |
| 1467637637 | Mac Innes Optical | Technician/Technologist | 885 Union Street, Suite 140, Bangor, ME 04401-3082 | 2008-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619530524 | Christopher Morgan Wheaton | Technician/Technologist | 93 Washington Ave Unit 2, Portland, ME 04101-2618 | 2019-04-16 |
| 1487898508 | Elizabeth A Morse | Technician/Technologist | 272 State Street, Optical Outlet, LLC, Brewer, ME 04412 | 2009-04-21 |
| 1346485240 | Gilbert A Poliquin | Technician/Technologist | 50 Lisbon St, Lewiston, ME 04240-7116 | 2008-12-05 |
| 1528216751 | Maine Professional Opticians and Hearing Aid Center | Technician/Technologist | 226 Western Ave, Augusta, ME 04330-6126 | 2008-08-29 |
| 1053455782 | Keeoli Corp Dba Vipeyes | Technician/Technologist | 1041 Brighton Ave, Portland, ME 04102-1042 | 2007-02-16 |
| 1427191907 | Falmouth Vision Center | Technician/Technologist | 204 Us Route One, Falmouth, ME 04105 | 2007-02-15 |
| 1386794196 | Village Optical,inc | Technician/Technologist | 464 Main St Centre, Damariscotta, ME 04543 | 2007-01-12 |
| 1548346950 | Wal-mart Stores East, Lp | Technician/Technologist | 525 Alfred St, Biddeford, ME 04005-6700 | 2006-10-27 |
| 1356439863 | Wal-mart Stores East, Lp | Technician/Technologist | 1240 N. Main St. Route 26, Oxford, ME 04270 | 2006-10-10 |
| 1699789123 | Us Vision Optical Inc | Technician/Technologist | 20 East Ave and Rt 196, Lewiston, ME 04240 | 2006-07-28 |
| 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.