Organization
SAM'S CLUB OPTICAL
Active
Other names
Sam's Club Optical 30-6520
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY C WILKINSON (NPI ASSOCIATE)
(479) 204-8320
Entity
Organization
Contact information
Practice address
5565 20TH ST, VERO BEACH, FL 32966-4632
(772) 978-0722
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0235
(479) 204-8320
(479) 277-8176
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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