SAM'S CLUB OPTICAL 30-4983 – NPI #1104095801
Technician/Technologist

SAM'S CLUB OPTICAL 30-4983 is a technician located in LAS VEGAS, NV. NPPES has assigned the NPI number 1104095801 to SAM'S CLUB OPTICAL 30-4983 on February 27, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SAM'S CLUB OPTICAL 30-4983” is a dba name, the actual legal business name for this organization is SAM'S CLUB OPTICAL. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 156FX1800X from the Health Care Provider Taxonomy code set, which is classified as Technician/Technologist, specializing in Optician

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SAM'S CLUB OPTICAL 30-4983 below.

NPI Profile for
SAM'S CLUB OPTICAL

NPI Number
1104095801
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SAM'S CLUB OPTICAL
Doing Business As (dba): SAM'S CLUB OPTICAL 30-4983
Primary location
7100 WEST ARROYO CROSSING PKWY
LAS VEGAS, NV 89113
Phone: (702) 260-7303 Fax:
Mailing address
702 SW 8TH ST.
BENTONVILLE, AR 72716
Phone: (479) 277-9373 Fax: (479) 277-8176
Organization Subpart
No
Authorized Official
DAVID SIMMONS
NPI ASSOCIATE
Phone: (479) 277-9373
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
156FX1800X
- Technician/Technologist / Optician (Primary)
332H00000X
- Eyewear Supplier

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.