Organization
SAM'S CLUB OPTICAL
Active
Parent organization
WAL-MART STORES INC
Other names
Sam's Optical Center 30-4728, Sam's Club Optical 30-4728
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
KIMBERLY CANONIC (SR DIRECTOR)
(480) 853-0515
Entity
Organization
Contact information
Practice address
103 BRYANT DRIVE, NICHOLASVILLE, KY 40356-9225
(859) 881-0695
(859) 881-0698
Mailing address
1 CUSTOMER DR, MS 0445, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
08/10/2010
Last updated
06/15/2026
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