Organization
SAM'S CLUB OPTICAL
Active
Other names
Sam's Club Optical 30-6489
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA M. EPPERSON (NPI COORDINATOR)
(316) 788-5580
Entity
Organization
Contact information
Practice address
603 RIVER OAKS W, CALUMET CITY, IL 60409-5408
(708) 889-9129
Mailing address
702 SW 8TH STREET, BENTONVILLE, AR 72716-0235
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
09/25/2006
Last updated
10/28/2008
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