| NPI | 1053403600 |
|---|---|
| Doing Business As | SAM'S CLUB OPTICAL 30-4804 |
| Entity Type | Organization |
| Authorized Contact | LINDA M. EPPERSON Npi Coordinator 316-788-5580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |