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Organization Active NPI

Sam's Club Optical

Doing business as Sam's Club Optical 30-6518

  • Optician
  • Bristol, VA
National Provider Identifier
1285828640
Registry record updated Aug 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
SAM'S CLUB OPTICAL
Doing business as
Sam's Club Optical 30-6518
Practice address
13249 Lee Highway
Bristol, VA 24202
Phone
(423) 282-4860
NPI assigned
Aug 29, 2007
Last updated
Aug 29, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2007

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

Authorized official

Name
Miss Sabrina Nicole Sutton
Title
Npi Associate
Phone
(479) 277-1175

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1800X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

13249 Lee Highway
Bristol, VA 24202

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0235
Phone (479) 277-1175

Other names 1

  • Sam's Club Optical 30-6518 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sam's Club Pharmacy823 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1285828640",
    "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": "479-277-1175",
            "fax_number": "479-277-8174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13249 LEE HIGHWAY",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "24202",
            "telephone_number": "423-282-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM'S CLUB OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "NPI ASSOCIATE",
        "authorized_official_telephone_number": "479-277-1175",
        "authorized_official_name_prefix": "Miss"
    },
    "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 30-6518",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bristol, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.