Organization
SAM'S CLUB OPTICAL
Active
Other names
Sam's Club Optical 30-8192
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NORMA B SMITH (MPI ASSOCIATE)
(479) 277-1703
Entity
Organization
Contact information
Practice address
3440 ROSS CLARK CIR, DOTHAN, AL 36303-2525
(334) 671-5005
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
07/17/2008
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