Organization
SAM'S CLUB OPTICAL
Active
Other names
Sam's Club Optical 30-
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NORMA B SMITH (MPI ASSOCIATE)
(479) 277-1703
Entity
Organization
Contact information
Practice address
4400 NORTH MAIN ST, ROSWELL, NM 88201
(505) 627-9852
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1703
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
03/16/2007
Last updated
08/22/2020
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