| NPI | 1104095801 |
|---|---|
| Doing Business As | SAM'S CLUB OPTICAL 30-4983 |
| Entity Type | Organization |
| Authorized Contact | DAVID J SIMMONS Npi Associate 479-277-9373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2008-02-27 |