Active NPI
Sam's Club Optical
Doing business as Sam's Club Optical 30-6650
- Eyewear Supplier
- Baltimore, MD
National Provider Identifier
1720174550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- SAM'S CLUB OPTICAL
- Doing business as
- Sam's Club Optical 30-6650
- Practice address
- 6410 Petrie Way Rd
Baltimore, MD 21237-3034 - Phone
- (410) 686-2683
- NPI assigned
- Oct 5, 2006
- Last updated
- Sep 11, 2025
- 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
- Linda M. Epperson
- Title
- Npi Coordinator
- Phone
- (316) 788-5580
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | Primary | ||
| Optician | 156FX1800X |
Addresses
Primary practice location
6410 Petrie Way Rd
Baltimore, MD 21237-3034
Mailing address
702 SW 8TH Street
Bentonville, AR 72716-0235
Other names 1
- Sam's Club Optical 30-6650
National Provider Directory
National Provider Directory- Tax ID family
- Sam's Club Pharmacy
Organizations with this tax ID in the same state 19
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Eyewear Supplier
- Salisbury, MD
- NPI 1124127642
Locations
6410 Petrie Way
Baltimore, MD 21237
Phone (410) 686-2683
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1720174550",
"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": "6410 PETRIE WAY RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212373034",
"telephone_number": "410-686-2683"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAM'S CLUB OPTICAL",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-05",
"last_updated": "2025-09-11",
"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": true
},
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Sam's Club Optical 30-6650",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.