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Sam'S East, Inc.

Organization Active NPI Eyewear Supplier · Woodstock, GA

NPI 1619347192 · NPPES record last updated Sep 28, 2015

Key facts

NPI
1619347192
Entity type
Organization (NPI type 2)
Primary specialty
Eyewear Supplier 332H00000X
Legal business name
SAM'S EAST, INC.
Practice address
9464 Main St
Woodstock, GA 30188-3715
Phone
(678) 402-0540
Fax
(770) 928-2013
NPI assigned
Sep 28, 2015
Organization subpart
Yes
Parent organization (as reported)
WAL-MART STORES, INC.

Authorized official

Name
Laura Levine
Title
Director of Contract and Enroll
Phone
(479) 204-8550

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Sam'S Hearing Aid Center 6332 (819 organizations share this tax ID)
Part of
Walmart Pharmact

Locations

9464 Main St
Woodstock, GA 30188
Phone (678) 402-0532

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 156FX1800X
Eyewear Supplier 332H00000X Yes

Addresses

Primary practice location

9464 Main St
Woodstock, GA 30188-3715

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0445

Other names

  • Sam's Club Vision Center 30-8158 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 28, 2015.

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443398400000",
    "number": "1619347192",
    "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": "727160445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9464 MAIN ST",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883715",
            "telephone_number": "678-402-0540",
            "fax_number": "770-928-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM'S EAST, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAL-MART STORES, INC.",
        "enumeration_date": "2015-09-28",
        "last_updated": "2015-09-28",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACT AND ENROLL",
        "authorized_official_telephone_number": "479-204-8550"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sam's Club Vision Center 30-8158",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodstock, GA

All providers in Woodstock, GA · Eyewear Supplier in Georgia

Sources for this page

Verify at the official NPI Registry.