SAM'S OPTICAL, PENN SQUARE, LLC


Address: 1900 Nw Expressway Ste R1-114, Oklahoma City, OK 73118-1802
Phone: 4056317558

SAM'S OPTICAL, PENN SQUARE, LLC (NPI# 1861639080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1861639080
Entity Type Organization
Organization Name SAM'S OPTICAL, PENN SQUARE, LLC
Other Organization Name SAM'S OPTICAL
Practice Address 1900 Nw Expressway Ste R1-114
Oklahoma City
OK 73118-1802
Practice Telephone 4056317558
Practice Fax Number 4056310615
Mailing Telephone 4056317558
Mailing Fax Number 4056310615
Enumeration Date 2009-01-09
Last Update Date 2009-01-09
Authorized Official Name MS. SHELLY BERTIN (CO-OWNER)
Authorized Official Telephone 4056317558
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 156FX1800X Technician/Technologist
Specialization: Optician
Eye and Vision Services Providers

Other Provider/Organization Names

Other Name Type Code
Sam's Optical Other Name - Individual/Organization

Office Location

Street Address 1900 NW EXPRESSWAY STE R1-114
City OKLAHOMA CITY
State OK
Zip Code 73118-1802

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255812772 Karrie Danea Moreno Behavior Technician 1507 Ne 31st, Oklahoma, OK 73118 2018-08-23
1528578499 Revive Medical LLC General Practice 4215 N Classen Blvd Ste 103, Oklahoma City, OK 73118 2017-10-05
1225556228 Anika Carr Case Manager/Care Coordinator 1212 Nw 32nd Street, Oklahoma City, OK 73118 2017-08-30
1740635168 Nikhil Malhotra Internal Medicine 3635 Vista Avenue At Grand Boulevard, 14th Floor, Desloge Towers, St. Louis, MO 73118 2016-05-04
1144694183 Christopher Woon Counselor 4001 N Classen, Suite 105, Oklahoma City, OK 73118 2015-11-13
1699181925 Stac Embry Counselor 3321 N. Mckinley Ave, Oklahoma City, OK 73118 2014-07-08
1194161216 Jennifer Kaye Powers Counselor 3124 N. Classen Blvd., Ste. A, Oklahoma City, OK 73118 2013-05-15
1932445491 Jessica Camp Behavioral Analyst 3220 N Harvey Pkwy, Oklahoma City, OK 73118 2013-01-02
1942578661 Michael D Danielson Behavioral Analyst 4232 N Sante Fe Ave, Oklahoma City, OK 73118 2011-12-08
1912280587 Tara Roberts Counselor 1743 Nw 37th, Oklahoma City, OK 73118 2011-09-21
Find all providers in zip 73118

Taxonomy Information

Taxonomy Code 156FX1800X
Grouping Eye and Vision Services Providers
Classification Technician/Technologist
Specialization Optician

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1376064592 Focus Optical Inc. Technician/Technologist 12444 Nw 10th St, Bldg H Ste 101, Oklahoma City, OK 73119 2017-06-28
1386814432 Sam's Crossroads Optical Technician/Technologist 1078 Crossroads Mall, Ste D, Oklahoma City, OK 73149-4202 2008-03-05
1255530754 Sam J Edwards Jr. Technician/Technologist 1078 Crossroads Mall Ste D, Oklahoma City, OK 73149-4202 2007-07-13
1396941712 Ronald Lee Brazell Technician/Technologist 1900 Nw 39th St, Oklahoma City, OK 73118 2007-06-22
1861696379 David Allen Trent Technician/Technologist 5631 N Pennsylvania Ave, Oklahoma City, OK 73112-7769 2007-06-11
1225135320 Tom W. Wilkinson Technician/Technologist 1010 N Pennsylvania Ave, Oklahoma City, OK 73107-6412 2006-09-20
1306463617 Sam's East, Inc. Technician/Technologist 5510 Sw 5th St, Oklahoma City, OK 73128-1216 2020-07-02
1407492465 Sam's East, Inc. Technician/Technologist 4101 N May Ave, Oklahoma City, OK 73112-6239 2019-11-25
1205472271 Sam's East, Inc. Technician/Technologist 1900 W Memorial Rd, Oklahoma City, OK 73134-6504 2019-11-25
1134765100 Sam's East, Inc. Technician/Technologist 9000 Nw Passage, Oklahoma City, OK 73132-3414 2019-11-25
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Competitor

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City OKLAHOMA CITY
Zip Code 73118

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Dataset Information

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.

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