NPIMap

Organization Active NPI

Sam's Club Optical

Doing business as Sam's Club Optical 30-8213

  • Optician
  • Columbus, GA
National Provider Identifier
1619038254
Registry record updated Jul 26, 2023
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 30-8213
Practice address
5448 'A' Whittlesey Blvd
Columbus, GA 31909
Phone
(706) 649-6377
Fax
(706) 649-6377
NPI assigned
Dec 13, 2006
Last updated
Jul 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Authorized official

Name
Mr. Matt McMullin
Title
Dir, Contracting
Phone
(479) 371-8711

Specialties & licenses 2

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

Addresses

Primary practice location

5448 'A' Whittlesey Blvd
Columbus, GA 31909

Mailing address

702 SW 8TH Street
Bentonville, AR 72716-0235

Other names 1

  • Sam's Club Optical 30-8213 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sams Club Optical821 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1619038254",
    "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": "5448 'A' WHITTLESEY BLVD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31909",
            "telephone_number": "706-649-6377",
            "fax_number": "706-649-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM'S CLUB OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "MCMULLIN",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "DIR, CONTRACTING",
        "authorized_official_telephone_number": "479-371-8711",
        "authorized_official_name_prefix": "Mr."
    },
    "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 30-8213",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sam's Club Optical 30-8213",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; 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.