Active NPI
Sam's Club Optical
Doing business as Sam's Club Optical 30-6644
- Optician
- Oakwood, GA
National Provider Identifier
1356516116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- Legal business name
- SAM'S CLUB OPTICAL
- Doing business as
- Sam's Club Optical 30-6644
- Practice address
- 3839 Mundy Mill Road
Oakwood, GA 30566 - Phone
- (770) 287-7716
- NPI assigned
- Apr 23, 2008
- Last updated
- Apr 23, 2008
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | NU | ||
| Optician | 156FX1800X | NU | Primary |
Addresses
Primary practice location
3839 Mundy Mill Road
Oakwood, GA 30566
Mailing address
702 SW 8TH St
Bentonville, AR 72716-0235
Phone (479) 277-9373
Other names 1
- Sam's Club Optical 30-6644
National Provider Directory
National Provider Directory- Tax ID family
- Sams Club Optical
Organizations with this tax ID in the same state 23
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Sam's Club Pharmacy 10-7658
- Community/Retail Pharmacy
- Brunswick, GA
- NPI 1316499437
Locations
3839 Mundy Mill Rd
Oakwood, GA 30566
Phone (770) 287-7716
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208908800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208908800000",
"number": "1356516116",
"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": "3839 MUNDY MILL ROAD",
"city": "OAKWOOD",
"state": "GA",
"postal_code": "30566",
"telephone_number": "770-287-7716"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAM'S CLUB OPTICAL",
"organizational_subpart": "NO",
"enumeration_date": "2008-04-23",
"last_updated": "2008-04-23",
"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": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Sam's Club Optical 30-6644",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Oakwood, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.