SAM'S CLUB OPTICAL (NPI# 1154412724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154412724 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-4936 |
| Practice Address |
6001 University Town Centre Dr. Morgantown WV 26534 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0235 |
| Practice Telephone | 3045983169 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | TAMMY J BOYD (CONTRACT COORDINATOR) |
| Authorized Official Telephone | 4792771359 |
| 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 30-4936 | 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 |
6001 UNIVERSITY TOWN CENTRE DR. |
| City | MORGANTOWN |
| State | WV |
| Zip Code | 26534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902404536 | Beverly Hess | Technician | 5603 Webster Springs Rd, Grafton, WV 26534 | 2020-10-15 |
| 1588262554 | Christina Conroy | Technician | 2139 Main St, Granville, WV 26534 | 2020-10-13 |
| 1598363426 | Patricia Kay Rosenberger | Technician | 109 Forbes Lane, Granville, WV 26534 | 2020-10-13 |
| 1326659244 | Olive Jean Carmody | Technician | 656 Miners Way, Apt 7b, Granville, WV 26534 | 2020-08-13 |
| 1255895421 | John Albert Brecht Iv | Student in an Organized Health Care Education/Training Program | 2040 Gyorko Drive, Granville, WV 26534 | 2019-01-22 |
| 1598841827 | Wal-mart Stores East, Lp | Technician/Technologist | 6051 University Town Centre Dr., Morgantown, WV 26534 | 2006-10-30 |
| 1255932489 | Debra Elizabeth Brady | Technician | 1070 Main Street, Granville, WV 26534 | 2020-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700879 | Anna Marie Vincent | Technician | 606 Brook Vw Apt F-6, Morgantown, WV 26508-6235 | 2020-11-06 |
| 1114528718 | Billie Jane Shrout | Technician | #4 Ami Dr, Morgantown, WV 26501 | 2020-11-02 |
| 1952901605 | George Paul Munas IIi | Pharmacist | 5605 University Town Centre Dr # 3215, Morgantown, WV 26501-2473 | 2020-10-30 |
| 1477153864 | Anna Howard | Technician | 66 Twin Knobs, Morgantown, WV 26508-2736 | 2020-10-27 |
| 1417557752 | Harriet Virginia Mayfield | Technician | 114 Clearwood Dr, Morgantown, WV 26508-6240 | 2020-10-27 |
| 1568061299 | Elaina Rennae Kirkendall | Technician | 1100 Andrew Dr, Morgantown, WV 26508-6842 | 2020-10-23 |
| 1326647207 | Carrie Stranko | Case Manager/Care Coordinator | 444 White Ave, Morgantown, WV 26501-6663 | 2020-10-21 |
| 1801495098 | Lynn Louise Kocan | Technician | 241 Cherry St, Morgantown, WV 26501-6113 | 2020-10-20 |
| 1023617164 | Elisabeth Gray | Technician | 107 Morgan Run Rd, Morgantown, WV 26508-2701 | 2020-10-20 |
| 1881292696 | Shaelee Nelson | Technician | 408 Skyview # D8, Morgantown, WV 26508-9276 | 2020-10-14 |
| Find all providers in MORGANTOWN | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598841827 | Wal-mart Stores East, Lp | Technician/Technologist | 6051 University Town Centre Dr., Morgantown, WV 26534 | 2006-10-30 |
| 1487754289 | Dawn Berardi | Technician/Technologist | 9601 Mall Rd, Morgantown, WV 26501 | 2006-09-22 |
| 1306324595 | Barbara Jean Hess | Technician/Technologist | 1 Stadium Dr, Morgantown, WV 26506-7900 | 2018-07-31 |
| 1013218080 | Parker James Doty | Technician/Technologist | 3142 Collins Ferry Rd, Morgantown, WV 26505-3352 | 2010-11-08 |
| 1285869230 | Diane Marie Byrd | Technician/Technologist | 3142 Collins Ferry Rd, Morgantown, WV 26505-3352 | 2009-05-20 |
| 1396858189 | Wal-mart Stores East, Lp | Technician/Technologist | 75 Retail Cir, Morgantown, WV 26508-1646 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528148 | Jordan Renee Morrison | Technician/Technologist | 139 Conference Center Way Ste 121, Bridgeport, WV 26330-9147 | 2020-11-05 |
| 1154585941 | Mary Jane Tudor | Technician/Technologist | 834 Robert C Byrd Drive Unit B, Sophia, WV 25921 | 2008-07-11 |
| 1871763862 | Wayne Dougherty Dba Wheeling Optical | Technician/Technologist | 1101 Market Street, Wheeling, WV 26003-2905 | 2008-03-05 |
| 1629257522 | Robert Martin Mustard II | Technician/Technologist | 210 1/2 North Street, Bluefield, WV 24701 | 2007-10-26 |
| 1033240429 | Wal-mart Stores East, L.p. | Technician/Technologist | 1 Tygart Valley Mall, Fairmont, WV 26554-3430 | 2007-03-08 |
| 1588711873 | Melvin Leroy Mckinney Sr. | Technician/Technologist | 605 Bland St, Bluefield, WV 24701 | 2007-01-05 |
| 1922178474 | Tea Vision Inc | Technician/Technologist | 5 Putnam Villiage, Teays, WV 25569 | 2006-11-09 |
| 1356410849 | Jennifer L Field | Technician/Technologist | 10565 Veterans Memorial Highway, Masontown, WV 26542-9577 | 2006-11-07 |
| 1235210212 | Wal-mart Stores East, Lp | Technician/Technologist | 1881 Robert C Byrd Dr, Beckley, WV 25801-8355 | 2006-10-18 |
| 1972690311 | Rebecca A. Lake | Technician/Technologist | 612 Rosebud Plz, Clarksburg, WV 26301-9386 | 2006-10-06 |
| Find all providers with the same taxonomy | ||||
| City | MORGANTOWN |
| Zip Code | 26534 |
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.