NPIMap

Organization Active NPI

Sam'S Club Optical

  • Optician
  • Elizabethtown, KY
National Provider Identifier
1770729626
Registry record updated Dec 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
SAM'S CLUB OPTICAL
Practice address
1500 Ring Rd
Elizabethtown, KY 42701-7984
Phone
(270) 769-1087
NPI assigned
Dec 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2008

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

Authorized official

Name
Holly C Wilkinson
Title
Optical Insurance Plan Review
Phone
(479) 204-8320

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1800X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

1500 Ring Rd
Elizabethtown, KY 42701-7984

Mailing address

702 SW 8TH Street
Bentonville, AR 72716-0235

Other names 1

  • Sam's Club Optical 30-4992 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sam'S Hearing Aid Center 6332819 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

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

View all 15

Locations

1500 Ring Rd
Elizabethtown, KY 42701
Phone (270) 763-0755

NPI Registry JSON

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

{
    "created_epoch": "1230076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230076800000",
    "number": "1770729626",
    "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": "1500 RING RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017984",
            "telephone_number": "270-769-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM'S CLUB OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-24",
        "last_updated": "2008-12-24",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OPTICAL INSURANCE PLAN REVIEW",
        "authorized_official_telephone_number": "479-204-8320"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sam's Club Optical 30-4992",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 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.