SAM'S CLUB OPTICAL (NPI# 1053403600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053403600 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-4804 |
| Practice Address |
1765 Jonesboro Rd Mcdonough GA 30253-5969 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 7709140488 |
| Enumeration Date | 2006-09-29 |
| 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 30-4804 | 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 |
1765 JONESBORO RD |
| City | MCDONOUGH |
| State | GA |
| Zip Code | 30253-5969 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811914153 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 1765 Jonesboro Rd, Mcdonough, GA 30253-5969 | 2006-07-16 |
| 1245831130 | Brittany Robinson | Pharmacist | 1765 Jonesboro Rd, Mcdonough, GA 30253-5969 | 2020-11-05 |
| 1124298252 | Gregory Wayne Peck | Optometrist | 1765 Jonesboro Rd, Mcdonough, GA 30253-5969 | 2008-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565159 | First Choice Home Health Care LLC | In Home Supportive Care | 600 Westridge Parkway, Suite 707, Mcdonough, GA 30253 | 2020-10-15 |
| 1164033783 | Tanequa S Dorsey | Counselor | 40 Macon Street, Suite D, Mcdonough, GA 30253 | 2020-08-17 |
| 1396369195 | Ikponmwosa Obakpolor | Physical Therapist | 234 Village Drive, Mcdonough, GA 30253 | 2020-06-08 |
| 1205392305 | Healthstat Onsite Clinic-henry County | Preventive Medicine | 141 Henry Parkway, Healthstat Clinic, Mcdonough, GA 30253 | 2019-02-13 |
| 1588128557 | Vernette R Mathurin | Licensed Practical Nurse | 97 Atl Street Suite 100, Mcdonough, GA 30253 | 2019-01-24 |
| 1083196836 | Peta-gaye C Pilote | Registered Nurse | 319 Regal Way E, Mcdonough, GA 30253 | 2018-08-29 |
| 1275021586 | Heritage Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 155 Westridge Pkwy Ste 217, Mcdonough, GA 30253 | 2018-04-23 |
| 1457853236 | Sherrille Greene | Counselor | 609 Autumn Leaf Circle, Mcdonough, GA 30253 | 2018-03-07 |
| 1376052696 | Kendra Oreggio | Private Vehicle | 117 Janney Circle, Mcdonough, GA 30253 | 2017-09-29 |
| 1245758788 | Pamela Hobbs | Home Health Aide | 5011 Monarch Dr, Mcdonough, GA 30253 | 2017-09-05 |
| Find all providers in zip 30253 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245484468 | America's Best Contacts & Eyeglasses | Technician/Technologist | 1128 Highway 81 West, Ste. A, Mcdonough, GA 30253 | 2008-11-14 |
| 1861871725 | The Eyecare Place LLC | Technician/Technologist | 42 Old Jackson Rd, Mcdonough, GA 30252-3029 | 2015-05-26 |
| 1447639604 | Chhaya Sei | Technician/Technologist | 42 Old Jackson Rd, Mcdonough, GA 30252-3029 | 2015-05-21 |
| 1659454585 | Wal-mart Stores East, Lp | Technician/Technologist | 135 Willow Ln, Mcdonough, GA 30253-6574 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427667302 | Carole F Medou | Technician/Technologist | 57 Hurricane Shoals Rd Nw Ste A, Lawrenceville, GA 30046-5396 | 2020-07-28 |
| 1255966206 | Steven W Burton | Technician/Technologist | 2498 Wingfield Dr, Austell, GA 30106-1762 | 2020-03-10 |
| 1477185205 | Dale A Klauss | Technician/Technologist | 294 Kenwood Rd Ste A, Fayetteville, GA 30214-3451 | 2020-02-10 |
| 1104380682 | National Vision Inc | Technician/Technologist | 97 Parkway Dr, Fort Oglethorpe, GA 30742-4249 | 2019-01-29 |
| 1134683600 | National Vision Inc | Technician/Technologist | 3159 Highway 278 Ne, Covington, GA 30014-2301 | 2019-01-29 |
| 1255818993 | Kerryn Castellon | Technician/Technologist | 55 Sudderth St, Buford, GA 30518-3335 | 2018-07-25 |
| 1770075731 | National Vision, Inc. | Technician/Technologist | 916 Loganville Hwy Ste 300, Bethlehem, GA 30620-2145 | 2018-06-05 |
| 1598262487 | National Vision, Inc. | Technician/Technologist | 534 Marketplace Pkwy Ste 740, Dawsonville, GA 30534-7549 | 2018-04-09 |
| 1720582992 | Amos D Washington | Technician/Technologist | 10269 Industrial Blvd Ne, Covington, GA 30014-1485 | 2018-03-21 |
| 1619490489 | Lisa Stonebraker | Technician/Technologist | 105 E Main St Ste 116, Woodstock, GA 30188-5013 | 2017-07-24 |
| Find all providers with the same taxonomy | ||||
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.