Organization
SAM'S CLUB OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE SUE HAYNES (SUPERVISOR)
(479) 204-8495
Entity
Organization
Contact information
Practice address
3410 55TH ST NW, ROCHESTER, MN 55901-0123
(507) 281-8355
(479) 277-8176
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
07/12/2006
Last updated
08/22/2020
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