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SAM'S CLUB OPTICAL NPI 1508957721


NPI Profile

NPI: 1508957721
Provider Name: SAM'S CLUB OPTICAL

Doing Business As: SAM'S CLUB OPTICAL 30-4830

Classification:Technician/Technologist - 156FX1800X
Entity Type: Organization

Specialization: Optician

CLIA Number: 03D2126723

Address:
1459 N DYSART RD
AVONDALE, AZ
ZIP 85323
Get Directions

Phone: (623) 882-3859

SAM'S CLUB OPTICAL is an optician technician technologist in Avondale, AZ. SAM'S CLUB OPTICAL NPI is 1508957721. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Sam's Club Optical 30-4830.

The provider's business location address is:

1459 N DYSART RD
AVONDALE, AZ
ZIP 85323-515
Phone: (623) 882-3859

The provider's authorized official is Linda M. Epperson .
The authorized official title is Npi Coordinator and has the following contact phone number (316) 788-5580.

The CLIA number assigned to this NPI record is 03D2126723 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/27/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1156FX1800XTechnician/TechnologistOpticianYes
2332H00000XEyewear SupplierX

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 6/14/2021

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.