# SAM'S CLUB OPTICAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sam's Club Optical 30-6678
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255464459
- **Authorized official:** MR. MATT MCMULLIN (NPI ASSOCIATE)
- **Authorized official phone:** (794) 371-8711

## Contact information

- **Practice address:** 289 MT NEBO POINT DR, PITTSBURGH, PA 15237
- **Practice address phone:** (412) 364-6737
- **Practice address fax:** (412) 364-5058
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-0235
- **Mailing address phone:** (479) 277-1703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 156FX1800X | Optician | — | NULL | Yes |
| 156FX1800X | Optician | — | — | Yes |
| 332H00000X | Eyewear Supplier | — | NULL | — |

## Other

- **Enumeration date:** 03/14/2007
- **Last updated:** 05/18/2023