SAM'S CLUB OPTICAL (NPI# 1114101193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114101193 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-4974 |
| Practice Address |
2650 East Craig Road North Las Vegas NV 89030 |
| Mailing Address |
702 Sw 8th St. Bentonville AR 72716-0235 |
| Practice Telephone | 7023993722 |
| Mailing Telephone | 4792779373 |
| Mailing Fax Number | 4792778176 |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2007-12-26 |
| Authorized Official Name | DAVID J SIMMONS (NPI ASSOCIATE) |
| Authorized Official Telephone | 4792779373 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers | ||
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| Sam's Club Optical 30-4974 | 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 |
| 1881876118 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 440 Payne Rd, Scarborough, ME 04074-8928 | 2007-11-28 |
| Street Address |
2650 EAST CRAIG ROAD |
| City | NORTH LAS VEGAS |
| State | NV |
| Zip Code | 89030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043819063 | Ma Guadalupe Ramos Michel | Technician | 2415 Reynolds Ave #101, Las Vegas, NV 89030 | 2020-10-21 |
| 1558968214 | Arturo Juarez Magana | Technician | 2415 Reynolds Ave Suite 101, Las Vegas, NV 89030 | 2020-10-06 |
| 1669088407 | Olivia Lizbeth Santillan-trinidad | Technician | 2415 Reynolds Ave. Ste #101, Las Vegas, NV 89030 | 2020-09-17 |
| 1508471640 | Fabian Aaron Alvarado-perales | Technician | 2415 Reynolds Ave Ste. 101, Las Vegas, NV 89030 | 2020-09-15 |
| 1063047934 | Adriana Lopez | Technician | 2415 Reynolds Ave., Ste 100, N. Las Vegas, NV 89030 | 2020-03-11 |
| 1881234078 | Blanca E Rangel Silva | Technician | 2810 Equador Ct, Las Vegas, NV 89030 | 2020-01-15 |
| 1598314445 | Julia Gonzalez | Technician | 2415 Reynolds Ave Suiete 100, Las Vegas, NV 89030 | 2019-09-04 |
| 1487201901 | Mayra Gutierrez | Technician | 2415 Reynolds Av. #100, Las Vegas, NV 89030 | 2019-08-20 |
| 1639725799 | Idalia Ruiz | Technician | 2415 Reynolds Ave, Las Vegas, NV 89030 | 2019-08-14 |
| 1548815616 | Rd Prabhu-lata K Shete Mds Ltd | Clinic/Center | 1905 Civic Center Drive, Ste 201, N. Las Vegas, NV 89030 | 2019-08-06 |
| Find all providers in zip 89030 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811485253 | James Kyles | Technician/Technologist | 4421 Valley Quail Way, North Las Vegas, NV 89084-2629 | 2018-05-01 |
| 1902937402 | Wal-mart Stores, Inc. Dba Wal-mart | Technician/Technologist | 3950 W. Lake Mead Blvd, North Las Vegas, NV 89032 | 2007-03-08 |
| 1962501445 | Wal-mart Stores, Inc. | Technician/Technologist | 6464 N. Decatur Blvd., North Las Vegas, NV 89084 | 2006-09-21 |
| 1417047416 | Wal-mart Stores, Inc | Technician/Technologist | 1807 W Craig Rd, North Las Vegas, NV 89032-0217 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497232730 | Tina Kosmach | Technician/Technologist | 7330 Eastgate Rd Ste 130, Henderson, NV 89011-4048 | 2018-07-19 |
| 1700120136 | Wal-mart Stores Inc | Technician/Technologist | 1511 Grant St, Gardnerville, NV 89410-7824 | 2012-11-26 |
| 1689928608 | Lovejeet Toor | Technician/Technologist | 3230 W Hacienda Ave Ste 301, Las Vegas, NV 89118-1717 | 2012-10-29 |
| 1659624500 | Andrea I Krohn | Technician/Technologist | 1684 Sabatini Dr, Henderson, NV 89052-4109 | 2012-10-16 |
| 1225295934 | James Crimi | Technician/Technologist | 10575 S Eastern Ave, #150, Henderson, NV 89052-5017 | 2008-05-20 |
| 1730302993 | Michael Erin Grover | Technician/Technologist | 4340 Valdez Way, Reno, NV 89502-4938 | 2007-04-10 |
| 1134240443 | Sean Russell Fericks | Technician/Technologist | 1657 Mountain City Highway, Suite 101, Elko, NV 89801-2459 | 2007-04-03 |
| 1598808511 | Nevada State Optical, Inc. | Technician/Technologist | 5595 S Virginia St, Suite B, Reno, NV 89502-6085 | 2007-02-15 |
| 1063568103 | Gem Optical | Technician/Technologist | 3300 E Flamingo Rd, Suite 20, Las Vegas, NV 89121-4398 | 2007-01-25 |
| 1790840692 | Wal-mart Stores, Inc. | Technician/Technologist | 5198 Boulder Hwy, Las Vegas, NV 89122 | 2006-12-22 |
| Find all providers with the same taxonomy | ||||
| City | NORTH LAS VEGAS |
| Zip Code | 89030 |
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.