| NPI | 1174612055 |
|---|---|
| Doing Business As | SAM'S OPTICAL 30-8248 |
| Entity Type | Organization |
| Authorized Contact | DIANNA PAINTER Enrollment Specialist 479-277-1238 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2011-11-08 |