NPIMap

Organization Active NPI

Sam's Club Optical

Doing business as Sam's Club Optical 30-6489

  • Optician
  • Calumet City, IL
National Provider Identifier
1306947379
Registry record updated Oct 28, 2008
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 30-6489
Practice address
603 River Oaks W
Calumet City, IL 60409-5408
Phone
(708) 889-9129
NPI assigned
Sep 25, 2006
Last updated
Oct 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Authorized official

Name
Linda M. Epperson
Title
Npi Coordinator
Phone
(316) 788-5580

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X
Optician 156FX1800X Primary

Addresses

Primary practice location

603 River Oaks W
Calumet City, IL 60409-5408

Mailing address

702 SW 8TH Street
Bentonville, AR 72716-0235

Other names 1

  • Sam's Club Optical 30-6489 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sams Club Optical823 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1306947379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH STREET",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 RIVER OAKS W",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095408",
            "telephone_number": "708-889-9129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM'S CLUB OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "EPPERSON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "NPI COORDINATOR",
        "authorized_official_telephone_number": "316-788-5580"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sam's Club Optical 30-6489",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Calumet City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.