SAM'S CLUB OPTICAL 30-4728 – NPI #1295040665
Eyewear Supplier

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Health Care Provider Taxonomy Code for Eyewear Supplier

SAM'S CLUB OPTICAL 30-4728 is an eyewear supplier located in NICHOLASVILLE, KY. NPPES has assigned the NPI number 1295040665 to SAM'S CLUB OPTICAL 30-4728 on August 10, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SAM'S CLUB OPTICAL 30-4728” 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 332H00000X from the Health Care Provider Taxonomy code set, which is classified as Eyewear Supplier.

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 30-4728 below.

NPI Profile for
SAM'S CLUB OPTICAL

NPI Number
1295040665
Enumeration Date

(about 16 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 30-4728
Primary location
140 KOHLS DR
NICHOLASVILLE, KY 40356
Phone: (859) 881-0431 Fax:
Mailing address
702 SW 8TH ST.
BENTONVILLE, AR 72716-0445
Phone: Fax:
Organization Subpart
Yes - SAM'S CLUB OPTICAL 30-4728 is subpart of another organization.
Authorized Official
DIANNA PAINTER
ENROLLMENT SPECIALIST
Phone: (479) 277-1238
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
332H00000X
- Eyewear Supplier (Primary)
156FX1800X
- Technician/Technologist / Optician

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.