NPIMap

Organization Active NPI

Sam's Club Optical

Doing business as Sam's Club Optical 30-

  • Optician
  • Roswell, NM
National Provider Identifier
1902920093
Registry record updated Aug 22, 2020
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-
Practice address
4400 North Main St
Roswell, NM 88201
Phone
(505) 627-9852
NPI assigned
Mar 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Norma B Smith
Title
Mpi Associate
Phone
(479) 277-1703

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X Primary

Addresses

Primary practice location

4400 North Main St
Roswell, NM 88201

Mailing address

702 SW 8TH St
Bentonville, AR 72716-6209
Phone (479) 277-1703

Other names 1

  • Sam's Club Optical 30- Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ability Network4,659 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902920093",
    "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": "727166209",
            "telephone_number": "479-277-1703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 NORTH MAIN ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "88201",
            "telephone_number": "505-627-9852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM'S CLUB OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "NORMA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MPI ASSOCIATE",
        "authorized_official_telephone_number": "479-277-1703",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "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-",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.