NPIMap

Organization Active NPI

Sam's Club Optical

Doing business as Sam's Club Optical 30-4770

  • Optician
  • Evans, CO
National Provider Identifier
1619125903
Registry record updated Aug 29, 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 30-4770
Practice address
3247 23Rd Avenue
Evans, CO 80620
Phone
(970) 330-1011
NPI assigned
Aug 29, 2008
Last updated
Aug 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2008

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

Authorized official

Name
Ms. Sabrina Sutton
Title
Npi Associate
Phone
(479) 277-1175

Specialties & licenses 2

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

Addresses

Primary practice location

3247 23Rd Avenue
Evans, CO 80620

Mailing address

702 SW 8TH Street
Bentonville, AR 72716-0235

Other names 1

  • Sam's Club Optical 30-4770 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network283 organizations share this tax ID, including this one

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1219968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1619125903",
    "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": "3247 23RD AVENUE",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "80620",
            "telephone_number": "970-330-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM'S CLUB OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-29",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_title_or_position": "NPI ASSOCIATE",
        "authorized_official_telephone_number": "479-277-1175",
        "authorized_official_name_prefix": "Ms."
    },
    "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 30-4770",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evans, CO

Sources for this page

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