Sam's Club Optical

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

SAM'S CLUB OPTICAL

Doing business as

Sam's Club Optical 30 4718

Practice address

11278 South Jordan Gtwy
South Jordan, UT 84095

Phone

(801) 545-9801

NPI assigned

Jul 2, 2008

Last updated

Jul 2, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David J Simmons

Title

Npi Associate

Phone

(479) 277-9373

Specialties & licenses 2

Addresses

Other names 1

• Sam's Club Optical 30 4718 Doing business as

Tax ID family

Sam's Hearing Aid Center 6332821 organizations share this tax ID, including this one

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1184886913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160235",
            "telephone_number": "479-277-9373",
            "fax_number": "479-277-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11278 SOUTH JORDAN GTWY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84095",
            "telephone_number": "801-545-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM'S CLUB OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "NPI ASSOCIATE",
        "authorized_official_telephone_number": "479-277-9373"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sam's Club Optical 30 4718",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nathan A. Sager, CRNA
• Hannah Salinas
• Salt Lake City Vamc
• Salt Lake MRI LLC
• Salt Lake Neuropsych
• Sams West Inc (Sams Pharmacy 10-4718)
• Marcela Marie Sanchez
• Carolyn Sandstrom
• Karen C. Sato, DPT, MBA
• Jamie Nelson Saunders, M.S., R.D.

• Optician in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Optician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.