SAM'S CLUB OPTICAL NPI 1902996960

NPI Information

  • NPI: 1902996960
  • Provider Name: SAM'S CLUB OPTICAL
  • Classification: Eyewear Supplier - 332H00000X
  • Entity Type: Organization
  • Doing Business As: SAM'S CLUB OPTICAL 30-6507
  • CLIA Number: 44D2137718
  • Address: 2120 EMPORIUM DR
    JACKSON, TN
    ZIP 38305
  • Phone: (731) 668-6958

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NPI Details

SAM'S CLUB OPTICAL is an eyewear supplier in Jackson, TN. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. SAM'S CLUB OPTICAL NPI is 1902996960. The provider is registered as an organization entity type.
The provider Is Doing Business As Sam's Club Optical 30-6507.

The provider's business location address is:

2120 EMPORIUM DR
JACKSON, TN
ZIP 38305-004
Phone: (731) 668-6958

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 44D2137718 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/13/2006 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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332H00000XEyewear SupplierYes
2156FX1800XTechnician/TechnologistOpticianX

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: 3/30/2025

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