SAM'S CLUB OPTICAL (NPI# 1215027214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215027214 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-4876 |
| Practice Address |
3200 Ken Bale Blvd Bowling Green KY 42103-6025 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 2707817768 |
| Enumeration Date | 2006-10-13 |
| 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 30-4876 | 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 |
3200 KEN BALE BLVD |
| City | BOWLING GREEN |
| State | KY |
| Zip Code | 42103-6025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700803046 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 3200 Ken Bale Blvd, Bowling Green, KY 42103-6025 | 2006-07-16 |
| 1902359318 | Cathy Jones | Pharmacist | 3200 Ken Bale Blvd, Bowling Green, KY 42103-6025 | 2016-08-02 |
| 1225581820 | Sam's | Public Health or Welfare | 3200 Ken Bale Blvd, Bowling Green, KY 42103-6025 | 2016-07-29 |
| 1962607267 | Whitney Leigh Gaskin | Optometrist | 3200 Ken Bale Blvd, Bowling Green, KY 42103-6025 | 2007-06-18 |
| 1225252943 | Barrett Simpson, O.d. LLC | Optometrist | 3200 Ken Bale Blvd, Bowling Green, KY 42103-6025 | 2007-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679127781 | Kw Consulting, LLC | Counselor | 1054 Searcy Way, Suite E, Bowling Green, KY 42103 | 2019-07-26 |
| 1063999662 | Southern Kentucky Surgicenter, LLC | Clinic/Center | 484 Golden Autumn Way, Suite 100, Bowling Green, KY 42103 | 2018-07-26 |
| 1780170936 | Midsouth Psychological Services, LLC | Psychologist | 996 Wilkinson Trce Ste A8, Bowling Green, KY 42103 | 2018-07-10 |
| 1760976146 | Prorehab Inc | Clinic/Center | 1110 Wilkinson Trce Ste 101, Bowling Green, KY 42103 | 2018-06-19 |
| 1063927671 | James Toney | Counselor | 624 Eastwood St, Bowling Green, KY 42103 | 2017-12-05 |
| 1366979528 | Laura Elizabeth Compton | Optometrist | 335 New Towne Drive, Bowling Green, KY 42103 | 2017-05-18 |
| 1033562632 | Elizabette Raby | Massage Therapist | 427 Us-31 Bypass, Suite 203, Bowling Green, KY 42103 | 2016-07-19 |
| 1831572460 | Casey Edward Travelsted | Dentist | 940 Us 31 W Bypass, Bowling Green, KY 42103 | 2015-07-01 |
| 1821435074 | Robert Louis Skaggs II | Dermatology | 1818 Wallace Court, Suite 301, Bowling Green, KY 42103 | 2013-05-29 |
| 1770893257 | Michelle Howell | Health Educator | 261 Moats Lane, Bowling Green, KY 42103 | 2010-10-18 |
| Find all providers in zip 42103 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952472904 | Smith Optical Company | Technician/Technologist | 730 Fairview Avenue, Suite B1a, Bowling Green, KY 42101-2367 | 2006-11-13 |
| 1366527996 | Wal-mart Stores East, Lp | Technician/Technologist | 1201 Morgantown Rd, Bowling Green, KY 42101-9202 | 2006-10-25 |
| 1164512687 | Wal-mart Stores East, Lp | Technician/Technologist | 150 Walton Ave, Bowling Green, KY 42104-6361 | 2006-10-13 |
| 1992716039 | Wal-mart Stores East, Lp | Technician/Technologist | 1120 S Main St, Bowling Green, OH 43402-4733 | 2006-08-11 |
| 1679563357 | Donneta Mccandless | Technician/Technologist | 1403 Andrea St, Bowling Green, KY 42104-3335 | 2005-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447898127 | Donald Keith Newland | Technician/Technologist | 8107 La Grange Rd, Louisville, KY 40222-3817 | 2019-12-12 |
| 1760045231 | Nancy M Naiser | Technician/Technologist | 140 W Pike St, Covington, KY 41011-2310 | 2019-04-19 |
| 1598229098 | Lisa Nicholas | Technician/Technologist | 1707 Cumberland Falls Hwy Ste U4, Corbin, KY 40701-2744 | 2019-01-29 |
| 1376011494 | Brian D Blevins | Technician/Technologist | 30 Highland Meadows Cir Ste 11, Highland Heights, KY 41076-1788 | 2018-11-06 |
| 1720578446 | Kenneth Antonio Shoats Jr. | Technician/Technologist | 1325 Bardstown Rd, Louisville, KY 40204-1319 | 2018-05-17 |
| 1922541937 | National Vision, Inc. | Technician/Technologist | Bldg 127 Gold Vault Ave, Fort Knox, KY 40121 | 2016-11-22 |
| 1932568235 | Wal-mart Stores East, Lp | Technician/Technologist | 6501 Veterens Memorial Pkwy, Crestwood, KY 40014-8694 | 2016-02-15 |
| 1740614866 | Christopher Michael Boston I | Technician/Technologist | 7951 Hopeful Church Rd, Florence, KY 41042-7922 | 2013-08-26 |
| 1003157199 | America's Best Contacts & Eyeglasses | Technician/Technologist | 4993-4995 Houston Road, Florence, KY 41042 | 2013-03-14 |
| 1982955274 | Mel Len Dukes | Technician/Technologist | 110 W Everly Brothers Blvd Ste G, Central City, KY 42330-2708 | 2012-09-26 |
| Find all providers with the same taxonomy | ||||
| City | BOWLING GREEN |
| Zip Code | 42103 |
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.