Organization
SAM'S CLUB OPTICAL
Active
Other names
Sam's Club Optical 30-6678
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT MCMULLIN (NPI ASSOCIATE)
(794) 371-8711
Entity
Organization
Contact information
Practice address
289 MT NEBO POINT DR, PITTSBURGH, PA 15237
(412) 364-6737
(412) 364-5058
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0235
(479) 277-1703
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
03/14/2007
Last updated
05/18/2023
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