SAM'S CLUB OPTICAL (NPI# 1417030941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417030941 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-8266 |
| Practice Address |
5600 Landers Rd Sherwood AR 72117-1903 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-6209 |
| Practice Telephone | 5019452167 |
| Enumeration Date | 2006-10-20 |
| 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 30-8266 | 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 |
5600 LANDERS RD |
| City | SHERWOOD |
| State | AR |
| Zip Code | 72117-1903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184225062 | Lisa Diane Wilson | Pharmacist | 5600 Landers Road, Sherwood, AR 72117 | 2020-11-05 |
| 1306475470 | Amir Amidi | Student in an Organized Health Care Education/Training Program | Baptist Health Family Medicine Residency Clinic, 3201 Springhill Dr., Suite 300, North Little Rock, AR 72117 | 2020-04-02 |
| 1699238147 | Achmed Munir Turay | Student in an Organized Health Care Education/Training Program | Baptist Health Medical Center- North Little Rock, 3333 Springhill Drive, Little Rock, AR 72117 | 2019-04-11 |
| 1548712227 | Arkansas Outpatient Surgery Center, LLC | Clinic/Center | 4331 W. 43rd, North Little Rock, AR 72117 | 2016-10-28 |
| 1982053286 | Amy Rainey | Nurse Practitioner | 3550 Springhill Dr, North Little Rock, AR 72117 | 2016-06-07 |
| 1558764159 | Premier Pharmacy Care LLC | Pharmacy | 760 Michaela Dr., North Little Rock, AR 72117 | 2014-09-27 |
| 1225458813 | Jennifer Lynn Duroy | Obstetrics & Gynecology | 3343 Springhill Dr Ste 3010, North Little Rock, AR 72117 | 2014-04-22 |
| 1285053686 | Jonathan Nicholas Chang | Obstetrics & Gynecology | 3343 Springhill Dr Ste 1005, North Little Rock, AR 72117 | 2014-04-14 |
| 1760820575 | Stefan Ceru Hemmings | Internal Medicine | 3401 Springhill Dr Ste 325, North Little Rock, AR 72117 | 2013-06-13 |
| 1104260629 | Pain & Ortho Products, LLC | Durable Medical Equipment & Medical Supplies | 4628 East 43rd, N Little Rock, AR 72117 | 2013-04-26 |
| Find all providers in zip 72117 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396155701 | Wal-mart Stores, Inc | Technician/Technologist | 21320 Sw Langer Farm, Sherwood, OR 97140 | 2014-05-07 |
| 1356726558 | Wal-mart Stores, Inc. | Technician/Technologist | 9053 Highway 107, Sherwood, AR 72120-2933 | 2015-07-29 |
| 1902988413 | Wal-mart Stores, Inc. | Technician/Technologist | 4450 E Mccain Blvd, Sherwood, AR 72117-2519 | 2006-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790223006 | Sam's West, Inc. | Technician/Technologist | 1517 Gene George Blvd, Springdale, AR 72762 | 2017-02-07 |
| 1639620099 | Sam's West, Inc. | Technician/Technologist | 1250 South Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1063837847 | Rick Rakotz | Technician/Technologist | 1400 N Devils Den Rd, Winslow, AR 72959-2605 | 2014-03-03 |
| 1841636206 | National Vision Optical | Technician/Technologist | Bldg 787 6th St., Little Rock, AR 72099 | 2013-05-13 |
| 1922355585 | Crystal Vision, Inc | Technician/Technologist | 2935 Lakewood Village Dr, North Little Rock, AR 72116-8033 | 2012-08-13 |
| 1336447887 | Steven Wayne Slane I | Technician/Technologist | 1001 W Walnut St Ste 6, Rogers, AR 72756-3525 | 2011-03-08 |
| 1053643817 | Mickey Lee Drake I | Technician/Technologist | 111 Ponderosa Ln, Suite H, Hot Springs Village, AR 71909-5018 | 2010-02-04 |
| 1235378589 | Zoella Kay Rogers | Technician/Technologist | 5111 Rogers Ave Ste 120p, Fort Smith, AR 72903-2033 | 2009-02-10 |
| 1609012053 | Lonnie E. Burrow | Technician/Technologist | 5909 R St, Little Rock, AR 72207-4417 | 2009-01-06 |
| 1346401650 | Traci L Wyatt | Technician/Technologist | 104 W Colt Square Dr, Suite 2, Fayetteville, AR 72703-2834 | 2008-06-19 |
| Find all providers with the same taxonomy | ||||
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| 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.