SAM'S CLUB OPTICAL (NPI# 1932200896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932200896 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6661 |
| Practice Address |
665 Mall Dr Portage MI 49024-2879 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 2693232700 |
| Enumeration Date | 2006-09-25 |
| 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 30-6661 | 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 |
665 MALL DR |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024-2879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053556340 | America's Best Contacts & Eyeglasses | Technician/Technologist | 6800 S Westnedge Ave Ste E, Portage, MI 49002-3557 | 2008-12-16 |
| 1376799486 | Bruce John Pelzek | Technician/Technologist | 215 W Cook St, Portage, WI 53901-2105 | 2008-08-08 |
| 1306004627 | Christine Savoy | Technician/Technologist | N8545 Staufenbeil Rd, Portage, WI 53901-9759 | 2008-05-23 |
| 1104264233 | Diana Lynn Haertel | Technician/Technologist | 215 W Cook St, Portage, WI 53901-2105 | 2013-06-11 |
| 1124101761 | Wal-mart Stores, Lp | Technician/Technologist | 8350 Shaver Rd, Portage, MI 49024-5441 | 2006-10-24 |
| 1376625293 | Wal-mart Stores East, Lp | Technician/Technologist | 6087 Us Highway 6, Portage, IN 46368-5046 | 2006-10-19 |
| 1043391964 | Wal-mart Stores East, Lp | Technician/Technologist | 2950 New Pinery Rd, Portage, WI 53901-9225 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588201420 | William Wise | Technician/Technologist | 410 North St, Otisville, MI 48463-9705 | 2019-12-10 |
| 1033750658 | American Eye Institute Optical Inc | Technician/Technologist | 2300 Haggerty Rd Ste 1100, West Bloomfield, MI 48323-2185 | 2019-10-04 |
| 1225595705 | National Vision Inc | Technician/Technologist | 1328 S Rochester Rd, Rochester Hills, MI 48307-3124 | 2019-02-21 |
| 1184191306 | National Vision Inc | Technician/Technologist | 50697 Waterside Dr, Chesterfield, MI 48051-4008 | 2018-10-25 |
| 1275045916 | W. Optical 4 LLC | Technician/Technologist | 1004 28th St Sw, Wyoming, MI 49509-2881 | 2017-11-03 |
| 1164932489 | Salim Rufo Auraha | Technician/Technologist | 3747 15 Mile Rd, Sterling Heights, MI 48310-5358 | 2017-10-02 |
| 1720527955 | Wal-mart Stores East, Lp | Technician/Technologist | 2755 W Holton-whitehall Rd, Whitehall, MI 49461 | 2017-02-21 |
| 1811434293 | Joseph Frye-dandridge | Technician/Technologist | 18669 Oakfield St, Detroit, MI 48235-3060 | 2017-01-24 |
| 1689110710 | W. Optical 2 LLC | Technician/Technologist | 3233 Alpine Ave Nw Ste A, Grand Rapids, MI 49544-1631 | 2017-01-12 |
| 1811377740 | Kat Stannis LLC | Technician/Technologist | 1794 N Old Us 23, Howell, MI 48843-7193 | 2015-06-05 |
| 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.