SAM'S CLUB OPTICAL (NPI# 1215024724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215024724 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-4787 |
| Practice Address |
200 American Blvd W Bloomington MN 55420-1120 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 9528881050 |
| 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 30-4787 | 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 |
200 AMERICAN BLVD W |
| City | BLOOMINGTON |
| State | MN |
| Zip Code | 55420-1120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356368757 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 200 American Blvd W, Bloomington, MN 55420-1120 | 2006-07-16 |
| 1265032593 | Tien Vuong | Pharmacist | 200 American Blvd W, Bloomington, MN 55420-1120 | 2020-10-27 |
| 1801494547 | Nunmoula Mazhari | Pharmacist | 200 American Blvd W, Bloomington, MN 55420-1120 | 2020-10-14 |
| 1619431517 | Philip Brett Moore | Pharmacist | 200 American Blvd W, Bloomington, MN 55420-1120 | 2019-01-24 |
| 1730460387 | Jason Layne Goetsch | Hearing Instrument Specialist | 200 American Blvd W, Bloomington, MN 55420-1120 | 2011-09-08 |
| 1841439015 | Marti Ellen Sandwick | Pharmacist | 200 American Blvd W, Bloomington, MN 55420-1120 | 2009-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457986556 | Jon Brookson Engfer | Counselor | 8609 Lyndale Avenue South, Bloomington, MN 55420 | 2020-03-09 |
| 1720624810 | Sunshine Assisted Living Services LLC | Home Health | 9540 Columbus Ave S, Bloomington, MN 55420 | 2019-11-23 |
| 1417205246 | Jrb Holdings, LLC | Home Health | 9897 Lyndale Ave S, Bloomington, MN 55420 | 2012-08-28 |
| 1629223722 | Jennifer Jean Bormann | Audiologist | 8714 Lyndale Avenue South, Minneapolis, MN 55420 | 2008-11-18 |
| 1801055959 | Sarah J. Marsden | Speech-Language Pathologist | 900 W 94th St., Bloomington, MN 55420 | 2008-06-04 |
| 1699949784 | 1st Choice Care, Inc. | Home Health | 9035 Blaisdell Ave S, Bloomington, MN 55420 | 2008-04-18 |
| 1922295203 | Cornerstone Advocacy Service | Community/Behavioral Health | 1000 East 80th St, Bloomington, MN 55420 | 2007-10-01 |
| 1184769457 | Fairview Oxboro Pharmacy Mtm | Non-Pharmacy Dispensing Site | 600 W 98th Street, Bloomington, MN 55420 | 2007-02-21 |
| 1891831723 | A Caring Company, Inc. | In Home Supportive Care | 9001 East Bloomington Freeway, Sutie 145, Bloomington, MN 55420 | 2007-01-29 |
| 1134279318 | Jennifer Mary Connelly | Speech-Language Pathologist | 9001 E Bloomington Fwy Ste 141, Bloomington, MN 55420 | 2007-01-11 |
| Find all providers in zip 55420 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841341898 | Visual Edge, Inc | Technician/Technologist | W 385 West Market, Mall of America, Bloomington, MN 55425 | 2007-01-16 |
| 1386744647 | Wal-mart Stores East, Lp | Technician/Technologist | 3201 West State Hwy 45, Bloomington, IN 47403 | 2006-09-25 |
| 1447264221 | Us Vision Optical Inc | Technician/Technologist | 2812 E 3rd St, Bloomington, IN 47401-5423 | 2006-07-28 |
| 1972868032 | America's Best Contacts & Eyeglasses | Technician/Technologist | 3275 W 3rd St, Bloomington, IN 47404-4835 | 2012-07-05 |
| 1073697629 | Wal-mart Stores, Inc | Technician/Technologist | 2225 W Market St, Bloomington, IL 61704-5014 | 2006-10-24 |
| 1811077191 | Wal-mart Stores, Inc. | Technician/Technologist | 715 E 78th St, Bloomington, MN 55420-1397 | 2006-10-17 |
| 1205937307 | Sam's Club Optical | Technician/Technologist | 3205 W State Road 45, Bloomington, IN 47403-5107 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821558370 | National Vision Inc | Technician/Technologist | 8348 Highway 7, Saint Louis Park, MN 55426-3907 | 2019-03-21 |
| 1861937112 | Personality Eyewear | Technician/Technologist | 8257 Logan Ave N, Brooklyn Park, MN 55444-1545 | 2016-12-22 |
| 1871961185 | Wal-mart Stores, Inc | Technician/Technologist | 3001 E Highway 7, Montevideo, MN 56265-4556 | 2015-09-03 |
| 1215316682 | National Vision, Inc. | Technician/Technologist | 12940 Riverdale Dr Nw, Ste 300, Coon Rapids, MN 55448-8412 | 2015-05-19 |
| 1619354156 | National Vision, Inc. | Technician/Technologist | 1727 Beam Ave, Ste D, Maplewood, MN 55109-1164 | 2015-05-05 |
| 1124437223 | America's Best Contacts & Eyeglasses | Technician/Technologist | 6096 Shingle Creek Pkwy, Brooklyn Center, MN 55430-2316 | 2014-08-04 |
| 1942622089 | Wal-mart Stores, Inc. | Technician/Technologist | 9300 East Point Douglas Rd S, Cottage Grove, MN 55016 | 2014-01-08 |
| 1851712384 | Marshall Allan Daly | Technician/Technologist | 2484 University Ave W, Saint Paul, MN 55114-1735 | 2013-12-31 |
| 1174966683 | David Yang | Technician/Technologist | 987 Oday St S, Maplewood, MN 55119-5953 | 2013-04-15 |
| 1063760817 | Wal-mart Stores Inc | Technician/Technologist | 1200 Shingle Creek Crossing, Brooklyn Center, MN 55430 | 2012-08-28 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 55420 |
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.