SAM'S CLUB OPTICAL (NPI# 1477646321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477646321 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-6624 |
| Practice Address |
1055 Harriman Pl San Bernardino CA 92408-4203 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 9097961505 |
| Enumeration Date | 2006-10-02 |
| 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 30-6624 | 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 |
1055 HARRIMAN PL |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92408-4203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447277678 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 1055 Harriman Pl, San Bernardino, CA 92408-4203 | 2006-07-16 |
| 1013452234 | Dr Julie Phan Od Inc | Optometrist | 1055 Harriman Pl, San Bernardino, CA 92408-4203 | 2016-12-23 |
| 1437558400 | Van T Nguyen | Pharmacist | 1055 Harriman Pl, San Bernardino, CA 92408-4203 | 2014-08-15 |
| 1487092813 | Julie Phan | Optometrist | 1055 Harriman Pl, San Bernardino, CA 92408-4203 | 2013-06-07 |
| 1902165798 | Cindy Tampoya Od Inc | Optometrist | 1055 Harriman Pl, San Bernardino, CA 92408-4203 | 2012-05-14 |
| 1912188327 | Firstsight Vision Services, Inc. | Optometrist | 1055 Harriman Pl, San Bernardino, CA 92408-4203 | 2007-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073124681 | Valeria Armentilla Cecena | Student in an Organized Health Care Education/Training Program | 1950 Sunwest Ln., San Bernardino, CA 92408 | 2020-08-17 |
| 1588272066 | Horizon Therapy Services | Physical Therapist | 418 East Vanderbilt, San Bernardino, CA 92408 | 2020-07-21 |
| 1821627639 | Bl Anderson Medical Corporation | Emergency Medicine | 473 E Carnegie Dr., Ste 200, San Bernardino, CA 92408 | 2020-04-03 |
| 1922648104 | Infinite Hope Hospice Corp | Hospice Care, Community Based | 225 W Hospitality Ln Suite 305, San Bernardino, CA 92408 | 2020-01-15 |
| 1689210775 | Inland Empire Community Outreach Center | Counselor | 473 East Carnegie Drive, Suite 200, San Bernardino, CA 92408 | 2019-11-23 |
| 1992347801 | Care Marriage and Family Therapists, Inc. | Marriage & Family Therapist | 1881 Commercenter Drive E, Suite 232, San Bernardino, CA 92408 | 2019-10-11 |
| 1366084360 | Theraville Counseling Services, A Licensed Clinical Social Worker Corp | Social Worker | 155 W Hospitality Ln Ste 245, San Bernardino, CA 92408 | 2019-10-10 |
| 1548730419 | Adriana Alcaraz | Behavior Technician | 473 E Carnegie, Ste 200, San Bernardino, CA 92408 | 2018-12-04 |
| 1811467889 | Xavier J Molina-williams | Behavior Technician | 476 E Carnegie Drive, Ste 200, San Bernardino, CA 92408 | 2018-12-03 |
| 1780153148 | Gillian Washington | Behavior Technician | 473 E Carnegie Dr, Ste 200, Riverside, CA 92408 | 2018-11-15 |
| Find all providers in zip 92408 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073166484 | Stephanie Alina Gomez | Technician/Technologist | 228 W Hospitality Ln Ste F2, San Bernardino, CA 92408-3268 | 2019-07-24 |
| 1700321304 | Mariano Salcedo | Technician/Technologist | 407 E Gilbert St, Unit 10, San Bernardino, CA 92404-5325 | 2017-01-05 |
| 1467536003 | Wal-mart Stores, Inc. | Technician/Technologist | 4001 Hallmark Pkwy, San Bernardino, CA 92407-1876 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374744 | John Dibos | Technician/Technologist | 343 W Felicita Ave Ste 10, Escondido, CA 92025-6515 | 2020-10-20 |
| 1720686140 | Lens 4 Less Optical, Inc. | Technician/Technologist | 343 W Felicita Ave # 10, Escondido, CA 92025-6515 | 2020-10-16 |
| 1023620648 | Blanca Estela Maldonado | Technician/Technologist | 671 E Cooley Dr Ste 102, Colton, CA 92324-4014 | 2020-08-17 |
| 1619598406 | Heather Siu Shum | Technician/Technologist | 200 E Garvey Ave Ste 109, Monterey Park, CA 91755-1859 | 2020-05-03 |
| 1932738481 | Enrique Metta Fallena | Technician/Technologist | 651 Palomar St Ste A17, Chula Vista, CA 91911-2663 | 2020-04-06 |
| 1629603659 | Linh Lai | Technician/Technologist | 1111 Story Rd Ste 1079, San Jose, CA 95122-2670 | 2020-03-10 |
| 1548895998 | Randy Liu | Technician/Technologist | 1049 Capen Ave, Walnut, CA 91789-3912 | 2020-03-05 |
| 1780214403 | Gary Alan Bates | Technician/Technologist | 2540 Zanella Way Ste 10, Chico, CA 95928-7194 | 2020-01-22 |
| 1336787696 | Michael Yoshio Sujishi | Technician/Technologist | 150 West Carson Street, Store 8839, Carson, CA 90745 | 2019-12-18 |
| 1609413665 | Yan Zlatin | Technician/Technologist | 21001 Sherman Way # 14a, Canoga Park, CA 91303-1760 | 2019-12-09 |
| Find all providers with the same taxonomy | ||||
| City | SAN BERNARDINO |
| Zip Code | 92408 |
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.